Accounting and Financial Services, Member Services
Reviews and sets up new claims. Determines liability and coverages. Investigates claims as necessary. Pays claims or denies claim payment. Assists claimants, insureds and other parties with claim related questions.
Essential Job Functions:
1. Receives and reviews new claims, sets up claim files, and maintains claim diary. Determines compensation levels of claims by reviewing liability and coverages. Sets file and reserves in computer system.
2. Investigates claims by contacting claimant, insureds, and other involved parties for additional information. Completes required documentation for recordkeeping purposes. Pays claims or sends denial letters as appropriate.
3. Handles various claims questions and other inquiries via telephone. Develops correspondence to claimants, providers, insureds, etc. as appropriate.
4. Assigns claims to independent adjusters, engineers and outside appraisers as appropriate.
5. Attends state meetings and gives presentations as requested.
6. Gives instructions to set up claims, make payments, complete forms or other clerical duties to Claims Technician or Claims Service Assistant.
Knowledge, Skills, and Abilities:
Knowledge of insurance claims process.
Knowledge of medical terminology.
Knowledge of mathematical principles and practices.
Knowledge of company products, services, policies, and procedures.
Knowledge of general office practices.
Skill in analyzing claims and making sound decisions using information at hand.
Skill in oral and written communication.
Skill in operating such office equipment as personal computer, Internet, e-mail, fax machine, copy machine, and claims software.
Ability to communicate with co-workers and customers in a professional manner.
Ability to maintain flexibility and responsiveness when faced with multiple work tasks and stressful situations.
Ability to prioritize multiple tasks.
Ability to maintain confidentiality.
Education and Experience:
High School diploma or equivalent, plus 1-2 years customer service and claims experience. Insurance related courses beneficial.
EEO Employer/Disabled/Protected Veteran
About Federated Rural Electric Insurance Exchange
Federated Rural Electric Insurance Exchange is the leading provider of property and casualty insurance for rural electric cooperatives in 42 states. Federated's primary goal is to offer its members affordable insurance coverage over the long term, so they can focus on serving their communities and making them better, safer, and more vibrant places to live.