Hybrid Claims Adjudicator

  • Location
    Madison, Wisconsin
  • Salary
  • Category
    Call Center & Customer Service - Customer Service

Adecco is partnering with an insurance company in Madison, WI to hire a Claims Adjudicator. This position allows remote work, but requires the ability to come into the office in downtown Madison, WI 2-4 times a month for meetings and events. 

Job Title:
Claims Adjudicator

Location: US-WI-Madison
Department: Preneed Claims 
Payrate Min/Max: USD $20.00/Hr./USD 
Scheduled Hours: 40, 8am - 4:30pm CST Monday - Friday 
Contract Duration: 6 months with the possibility of being hired on. 

The Claims Adjudicator is responsible for processing claims, effectively communicating and
corresponding with external and internal customers including policyholders, agents, funeral directors,
and beneficiaries. Additional responsibilities include processing various types of claims and service
requests along with providing phone support accurately within or exceeding existing service goals. In
this role, work is performed under general supervision. The position requires the need to conduct
additional research and to accurately document all findings as deemed appropriate.

1. Accurately adjudicate claims within stated service goals.
a. Follow established written processing procedures
b. Verify proper forms are received according to state regulation
c. Accurately enter and process:
i. Whole life
ii. Term Life
iii. Universal life & Interest sensitive
iv. Acquisition Preneed
v. Final Expense
vi. Preneed
vii. Trust claims including Tru Trust, NGL Funeral Expense Trust, and NGL Estate Planning
viii. Preneed Texas including accurate reconciliation and file documentation verification.
ix. Annuities
x. Contestable claims including referring claims to Underwriting as needed.
xi. Rider claims including accidental death, child/family rider, and spouse rider.
d. Accurately calculate cost basis on basic annuity claims
e. Follow-up timely on all claims in writing within state regulated time frames

2. Provide phone support for all claims related calls and letter correspondence
a. Ability to effectively communicate, with empathy when appropriate, to our customers verbally,
in writing, and via email
b. Ability to actively listen and appropriately respond to others
c. Provide phone support for claims related calls while maintaining team service goals
d. Contact agents, funeral homes beneficiaries, and other customers to obtain missing
information when needed
e. Prepare proper correspondence for all steps in the claim process and as needed to respond to
customer inquires

3. Team Work
a. Ability and willingness to work with others in a team environment
b. Participate in group decision making, listening, and responding constructively to others
c. Offer help to teammates when the need arises
d. Manage and adjust personal time off, breaks, and lunches to insure sufficient team coverage
e. Help ensure that team standards and goals are maintained

4. Problem Solve
a. Transfer knowledge from one process and apply it to another like process regarding common
b. Able to gather most needed data and petition input to help recognize the symptoms and root
causes of distinct problems
c. Examine defined issues with ambiguous causes
d. Suggest alternative approaches that meet the needs or the organization, the situation, and
those involved
e. Resolve difficulties and escalate issues with suggestions for additional inquiry

5. Accurately research insured status
a. Follow established written processing procedures
b. Search databases to confirm Insured status
c. Update spreadsheets and document appropriately

6. Complete assigned projects, tasks, and/or milestones by agreed upon due dates including
performing other related work as requested or required

Knowledge, Skills, and Abilities
• Intermediate knowledge of NGL and acquisition products and procedures
• Intermediate communication skills--oral and written
• General PC and office machine knowledge
• Typing skills of at least 45 words per minute and 5500 keystrokes per hour alphanumeric
• Knowledge of basic accounting skills
• Ability to work in a team environment
• Organized and detail oriented
• Ability to quickly search the Internet and other databases

If you are interested in this role, please apply with your up to date resume. 

Pay Details: $20.00 per hour

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.adeccousa.com/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records subject to federal contractor requirements and/or security clearance requirements.

  • Apply with Adecco

Reference number US_EN_99_026914_2265501