February 09, 2024

Complex Claims Analyst

Locations: Baton Rouge, LA; Lincoln, NE; Cedar Rapids, IA; Des Moines, IA; Rosemont/Chicago, IL; Remote/WFH

Kuvare is a growth-oriented insurance platform that delivers diversified annuities, life insurance, and supplemental products to the middle-income and mass-affluent consumer segments through its acquisition-led growth strategy. Kuvare provides proven capabilities, strategic support, substantial resources, and patient capital to help insurance companies pursue and achieve sustainable growth opportunities. With its patient capital, Kuvare targets differentiated annuity and life insurance companies to bring into its family of brands.

Summary/Objective

The Complex Claims Analyst is responsible for handling all Life claims including Living Benefits (disability, waiver of premium and accelerated benefit riders) and contestable life claims in accordance with internal guidelines. Responsibilities include assistance with legal, special investigation unit, finance, actuarial and operational support.

Duties and Responsibilities

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Reviews and investigates Living Benefits, disability claims and Life Claims by using telephone and written contact with the applicable parties, (claimant, employer/supervisor, credit union, treating physician, to gather pertinent data to analyze the claim
  • Approve claim decisions, disability management strategies and payments on complex or higher liability claims
  • Handle routine phone inquiries from, or to, disability claimants and/or respective clients
  • Reviews evidence and renders determination for ongoing benefits on Continuing Disability Review claims
  • Quality checking pending disbursements for outgoing claim payments
  • Must have excellent verbal and listening skills, be detailed oriented and have the desire and ability to provide customer service in a professional positive manner while maintaining an empathetic voice with the customer/agent
  • Takes ownership of complex cases and escalates to management as appropriate
  • Works autonomously within established guidelines with a limited degree of supervision
  • Investigation, analysis and resolution of escalated and complex claim cases
  • Escalate claim resolution to management when necessary
  • Organize work/resources to accomplish objectives and meet deadlines
  • Maintain compliance with federal and state regulations and reinsurance treaty provisions.
  • Maintain the privacy and security of all confidential and protected information; uses and discloses only that information which is necessary to perform the function of the job
  • Demonstrate the willingness and ability to work collaboratively with other key internal and external staff to obtain necessary information both internal and external partners.
  • Participate in all educational activities and demonstrates personal responsibility for job performance
  • Take initiative for learning new skills and willingness to participate and share expertise on projects, committees and other activities, as deemed appropriate
  • Consistently demonstrate a positive and professional attitude at work
  • Maintain compliance with established corporate and departmental policies and procedures
  • Management retains the discretion to add or change the duties of the position at any time.

Requirements

Experience

  • Minimum of 3 years of experience handling Life insurance claims.
  • Preferably extended experience with companion products, LTC, Pre-need, Disability Income, Waiver of Premium, etc.
  • College degree desired, equivalent claims experience will be accepted.
  • Life Office Management Association certifications or comparable experience.

Skills/Competencies

  • Strong verbal, written and listening communication skills
  • Strong risk assessment, negotiation and conflict resolution skills.
  • Strong interpersonal skills
  • Ability to collaborate with key partners and business leaders
  • Ability to read and interpret contract language
  • Proficient on Microsoft Office
  • Ability to work independently with minimal supervision
  • Demonstrated ability to deliver results under pressure in a tight timeframe preferred
  • Knowledge of annuities and life plans and processes highly desirable
  • Proven track record of process improvement and innovation desirable
  • Specific skills or abilities the successful employee will possess

Physical Demands

  • Normal office working environment
  • Ability to sit for extended periods of time
  • Ability to type / perform data entry
  • Ability to read from a computer screen and paper reports
  • Express ideas and otherwise communicate with the spoken word

Kuvare company is an equal opportunity employer that makes hiring decisions based on merit, qualifications, and the business need. We are dedicated to a policy of nondiscrimination in employment on any basis including age, sex, color, race, creed, national origin, religious persuasion, marital status, political belief, or disability that does not prohibit performance of essential job functions. We encourage all qualified candidates to apply.

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