Claims Representative, Operations

Company Overview and Culture EXL (NASDAQ: EXLS) is a global analytics and digital solutions company that partners with clients to improve business outcomes and unlock growth. Bringing together deep domain expertise with robust data, powerful analytics, cloud, and AI, we create agile, scalable solutions and execute complex operations for the world’s leading corporations in industries including insurance, healthcare, banking and financial services, media, and retail, among others. Focused on creating value from data for driving faster decision-making and transforming operating models, EXL was founded on the core values of innovation, collaboration, excellence, integrity and respect. Headquartered in New York, our team is over 40,000 strong, with more than 50 offices spanning six continents. For information, visit www.exlservice.com.

For the past 20 years, EXL has worked as a strategic partner and won awards in its approach to helping its clients solve business challenges such as digital transformation, improving customer experience, streamlining business operations, taking products to market faster, improving corporate finance, building models to become compliant more quickly with new regulations, turning volumes of data into business opportunities, creating new channels for growth and better adapting to change. The business operates within four business units: Insurance, Health, Analytics, and Emerging businesses.

Job Title:Claims Representative, Operations

Brief Job Description:

The mission of this job is to promptly analyze policy files to determine and pay correct policy death benefits and beneficiaries and to handle incoming calls related to the death benefits.

Responsibilities:

• Accountable for identifying, investigating, evaluating, obtaining and utilizing critical information required to accurately and objectively adjudicate claims.
• Verbally communicate and correspond with outside customers to convey claim filing requirements.
• Handles claim inquiries and processing on multiple product lines.
• Documents all calls clearly and concisely and completes follow-up work.
• Identify areas of potential risk for the company, including potential fraud.
• Analyze all incoming documents for appropriateness and completeness, and determine whether claim is payable. If so, calculate benefit amounts and serve as 1st approver for payments.
• Serves as the first step in resolving claims adjudication issues and in the call escalation process.
• May be responsible for incoming and outgoing calls to claimants, Power’s of Attorney, facilities and other person’s or entities involved in the adjudication of a claim.
• Ensure all tax information is correctly reported.
• Maintain claim file with proper level of documentation.
• Answer customer inquiries.
• Maintain claim inventories within departmental, contractual, and regulatory guidelines.

Basic Qualifications:

• Death claims processing for life and/or annuity contracts preferred
• Two-year college degree or equivalent experience in a financial institution operations department, customer service, or annuity product experience.
• Knowledgeable in life or annuity products and death claim processing
• Must have sharp attention to detail and ability to perform with high degree of accuracy.
• Strong analytical skills to review documents and reach sound decisions
• Proven oral and written communication skill set.

• Ability to:

◦ Meet multiple performance targets at or above benchmark levels; including, but not limited to: accuracy, call quality, timeliness, and productivity. ◦ Work harmoniously with peers within a small team environment to accomplish both personal and team performance goals. ◦ Work with customers in a professional and empathic manner ◦ Work overtime, as needed, to meet daily deadlines ◦ Work simultaneously with multiple computer systems ◦ Compute moderately difficult mathematical calculations

• Available for 8 hour shift between 8am to 8pm working hours; Work from home

EEO/Minorities/Females/Vets/Disabilities

Please be aware that EXL requires all employees to be vaccinated for COVID-19. This position will require the successful candidate to obtain and show proof of a vaccination. EXL is an equal opportunity employer, and will provide reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law.

Please also note that the data shared through the job application will be stored and processed by EXL in accordance with the EXL Privacy Policy.

"Base Salary Range Disclaimer: The base salary range represents the low and high end of the EXL base salary range for this position. Actual salaries will vary depending on factors including but not limited to: location and experience. The base salary range listed is just one component of EXL's total compensation package for employees. Other rewards include bonuses and/or commission, as well as a Paid Time Off policy, and many region specific benefits

Originally posted on Himalayas