Claims Support Analyst - Quality

Claims Support Analyst

AAA Life is a respected and trusted American brand that has been focusing on Life Insurance and Annuity Products since 1969. At AAA Life we have over 1.8 million policies where we take pride in earning the trust of our policyholders who understand our promise to be there for them and their families when we're needed most. By joining the AAA Life team, you are joining a company that genuinely cares about helping each other, with a devotion to protect the lives of those around us. We embrace a diverse, equitable, inclusive culture where all associates can feel a sense of belonging and use their unique talents and perspective to influence, innovate, motivate, and thrive.

The Claims Support Analyst will conduct audits of claim files, respond to customer inquiries, and service related issues, first line support on escalated claims. Assist with workflow management and aid in the process of developing training and documentation.

Responsibilities

What You'll Do

• Performs quality audit of claim files (paid, pended, and denied by staff) to ensure adherence to process, procedures, and regulatory compliance within scope of authority.
• Preforms quality reviews of phone call, payments, letters, service recovery tickets, etc.
• Assist with training and the development of training.
• Prepares responses involving complex matters on customer inquiries Responses are oral and written for various audiences (Department of Insurance, Customers, Attorney's, etc).
• Acts as a mentor on claim matters to aid in the development and training of existing staff, to improve quality, judgment skills, decision making abilities, and productivity based on audit results.
• Ensure training needs for the department are fulfilled and documentation exists for all processes. May audit telephone calls and claim files to assist with quality program and ongoing development of staff.
• Identifies improvements to correspondence, claim analysis and adjudication process based on philosophies and procedures. Collaborate with Claims Manager and Business partners as necessary when pursuing resolution of areas needing improvement.
• Identifies system enhancement needs to reduce manual processing.
• Assists with the design, creation and delivery of training materials in a variety of media or instructional delivery methodologies. Special emphasis should be given to regulatory guidelines.
• Approves claim payments and denials within scope of authority.
• Primary contact for vendors of claims department.
• Participates on project teams and works effectively with departments involved.

Qualifications

What do you offer?

• Bachelor's degree preferred or equivalent experience
• FLHC Designation Completion within 36 months of job acceptance

What We offer:

• A collaborative, energetic work environment where you can put your passion for people to work
• Medical, Dental, Vision, Life and Disability coverage available day one
• Pension Plan
• Performance-based incentive plan
• 401k available with a Company match
• Holidays and Paid Time Off
• AAA Basic Membership

While performing the duties of this job, the employee is frequently required to stand, walk, sit, use hands to finger, handle, or feel, talk, hear and concentrate. Specific vision abilities required by this job include close vision, distance vision, depth perception, and ability to adjust focus.

This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements. Reasonable accommodation will be made for otherwise qualified applicants as needed to enable them to fulfill these requirements.

We are committed to ensuring equal employment opportunities for all job applicants and employees. Employment decisions are based upon job-related reasons regardless of an applicant's race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, marital status, genetic information, protected veteran status, or any other status protected by law.