Claims Advocate II

AAA Life Claims Advocate II

By joining AAA Life, you will have the opportunity to strengthen the name and reputation of the brand that millions have come to rely upon for financial peace of mind. We are company dedicated to our members and our employees! We value the unique attributes and contributions of our associates to build an inclusive, collaborative and innovative workplace where all employees are engaged and feel they belong. Delivering our company's promise to members is what drives each of our associates every day!

We offer a dynamic work environment, excellent benefits, and competitive compensation, that will allow you to exercise your potential to innovate, finding ways to increase efficiency and enhance our business processes.

This is a hybrid position in our Livonia, MI office.

Responsibilities

Consistent with our service philosophy of speed, accuracy, and style, the Claims Advocate II analyzes, evaluates, and determines final decision for life, accidental injury & death, simple annuity and rider claims within scope of authority and experience level in accordance with established departmental and statutory guidelines. May consult with senior claims staff of management regarding claim situations that require assistance. Has authority to approve or deny claims within specified authority. Provides secondary signature for claims adjudicated by other team members within scope of authority. Has authority to resolve complaints and is actively involved in procedure development. Communicates with members, beneficiaries, and legal representatives to appropriately adjudicate a claim. Provides guidance and support regarding questions on claim files to less tenured team members. Senior Claims Examiner or Claims Consultant review cases outside of prescribed limits and authority.

Qualifications

• Prior experience with AS400 in end-to-end claims processing is strongly preferred.
• Associate Degree, medical certification, or equivalent related work experience required.
• Minimum 3 years' experience in Life / Health Insurance or Claims processing experience or related field required.
• Life insurance underwriting experience including knowledge and understanding of medical conditions, impairments and the financial and legal aspects of risk selection and other factors pertaining to acceptability and assessment of life insurance applications, preferred.
• Demonstrates knowledge of HIPAA, Privacy, ACLI Guidelines, Unfair Claims Settlement Act / Laws, Life Insurance and Medical Terminology.
• Proficient using internet based applications and Microsoft office products, specifically Word and Excel.
• Able to perform basic mathematical calculations to include addition, subtraction, multiplication, division, and percentage.

What We Offer :