PFML Claims Analyst

Responsibilities

As a PFML Claims Analyst, your day will be anything but routine. In this fast-paced environment, every single day offers new challenges and the ability to use your excellent analytical, multitasking, prioritization, and interpersonal skills to assist with our clients’ short-term disability claims – all during a time in which they may be facing major changes in life.

Here are a few examples of the kinds of things you’ll do:

• Acquire, analyze, and investigate medical, financial and contractual information to make effective and timely claim decisions.
• Connect with employers, employees and medical providers via phone, email, text, and letters.Connect with employers, employees and medical providers via phone, email, text, and letters.
• Provide support to phone agents whenever they ask assistance through Helpline channel
• Provide customers with updates regarding medical conditions, restrictions & limitations, job duties, PFML policy provisions, claim decisions, status, and all other aspects of the claim process to ensure they fully understand the companys position.
• Supervise and follow up on outstanding items to ensure compliance with regulations, service timing, and quality guidelines.
  
  

What else do you need to know? This position offers you an exciting, yet rewarding career where you can make an impact in the lives of many of our clients. Although you may need to make some impactful decisions, we equip you with the training, tools and resources to allow you to be successful!

Qualifications

Qualifications

Requirements Information

Provide prompt, courteous, and excellent service at an acceptable cost to all customers; operate in an ethical manner in accordance with all applicable laws and regulations, the companys Corporate Code of Ethics, employee handbook, applicable compliance and operations policies and procedures, and other policies of the company. Possess a high degree of integrity and actively cooperate and interact with all entities of the Principal Financial Group.

Qualifications

• PHRN with active license. Bachelors degree, with 2+ years Claims background
• Non-PHRN (Bachelor/ Associates degree) with solid 2+ years of customer facing work experience (Healthcare)
• Claim Processing Experience – reviewing and gathering information, making phone calls, and making the actual claim decision - at least 2 years or more of successful performance of processing claims preferred.
• Legal and policy experience - being able to read, interpret policies, policy provisions and industry regulations to accurately interrupt and apply them to claims situations is preferred.
• Basic math skills.
• Ability to actively listen while you collect information on the telephone and provide strong customer service, providing empathy to the customers going through tough situations.
• Ability to accept & apply feedback.
• Ability to maintain a high degree of accuracy, pay strict attention to detail, maintain confidentiality, and work within the grey.
• Excellent analytical, interpersonal, problem solving, decision-making, and multi-tasking skills.
• Computer skills and typing proficiency – Microsoft Outlook, Word, Excel experience is preferred.
• Work independently as well as in a team environment.

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