Operations CIF Specialist
Gainwell Technologies LLC
Location
Roseville, CA | United States
Job description
Summary
Your role in our mission
Essential Job Functions
- Analyzes insurance and matured endowment claims to ensure compliance with organizational and government guidelines.
- Maintains an ongoing effort to determine and maintain equity with current claims trends.
- Conducts analysis of current claims trends and investigates means to improve claim processes. Recommends improvements and implements same as approved.
- Researches and investigates claims systems to evaluate potential impact to organization. Recommends adjustments or changes to systems as appropriate.
- Analyzes claims financial reporting practices and reconciliation for client companies. Identifies issues and recommends alternative courses of action.
- Informs management of potential liabilities or process improvements related to current claims practices.
Basic Qualifications
- Bachelor's degree or equivalent combination of education and experience
- Bachelor's degree in insurance, business administration or related field preferred
- Three or more years of claims experience
- Experience working with standard industry claims processing systems and tools
- Experience with investigating internal claims practices
- Experience working with appropriate claims processing procedures and documentation, and administrative procedures, legislative requirements, and medical principles as they relate to examination and approval of life and disability insurance claims
Other Qualifications
- Good analytical and problem solving skills
- Good interpersonal skills to interact with team members
- Good communication skills to communicate with clients
- Good human relations skills to provide leadership and work guidance to less experienced personnel
- Ability to keep sensitive and confidential material private
- Ability to work in a team environment
Work Environment
What we're looking for
What you should expect in this role
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Job tags
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