United States only- Determine extent of liability on routine and non-routine claims and make final claim decisions within specified dollar limits. Contribute to accurate fraud detection and reporting by referring suspected fraud to appropriate staff for review according to established procedures.
- Analyze claim transactions and process payments utilizing various work flow, administrative, and LOB (Line of Business) systems, accurately and cost effectively according to contract provisions and in compliance with internal service and state and federal regulatory standards.
- Ensure high level of customer satisfaction by partnering with members, financial associates, doctors, providers, attorneys, police, vendors and other internal and external customers regarding claims, settlements and interpretation of policy provisions, which may include highly confidential information or complaints, often educating the recipient on products/benefits and regulatory requirements.
- Handle sensitive written and verbal communications. May be called upon to influence behavior via these communications.
- Actively participate in the development and implementation of business processes, standard operating procedures, documentation and other support materials required for unit operation. May also analyze data and offer remediation in response to audit inquiries or compliance examinations as determined by the Claims Consultant.
- Provide consultation to Associate Claims Examiners in helping to answer questions and make decisions on claims with a moderate level of complexity.
- High school required. College degree preferred.
- Minimum of 2 years relevant experience.
- Professional credentials preferred (e.g. LOMA, ICA).
- Intermediate knowledge of claim administration and operations as well as pertinent laws and regulations.
- Must possess strong interpersonal skills, as well as excellent verbal and written communication skills.
- As part of Thrivent Financial's hiring process, a verification of a candidate's background will be made to complete the hiring process.
- May represent the company at depositions and court appearances.
Thrivent provides Equal Employment Opportunity (EEO) without regard to race, religion, color, sex, gender identity, sexual orientation, pregnancy, national origin, age, disability, marital status, citizenship status, military or veteran status,genetic information, or any otherstatus protected by applicable local, state, or federal law. This policy applies to all employees and job applicants.
Thrivent is committed to providing reasonable accommodation to individuals with disabilities. If you need a reasonable accommodation, please let us know by sending an email to human.resources@thrivent.com or call 800-847-4836 and request Human Resources.
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