Senior Claim Adjudicator
Current- Adjudicate life claims including identifying, collecting and reviewing all relevant information needed to determine the claim legitimacy and eligibility.
- Provide accurate and appropriate information, verbally and written, in response to customer and agent inquiries.
- Distributes work evenly amongst colleagues to ensure timely completion of assignments while adhering to service standards.
- Cross reference systems to ensure the correct beneficiaries are paid the correct amounts.
- Determine which claims need to be referred for evaluation and decision, based on authority limits, business case issues or referral to legal counsel.
- Work collaboratively with outside sources such as medical consultants, legal consultants, independent physicians, coroners, police or investigative services in order to process, validate, or falsify claims.