Claims Settlement & Compliance Specialist

Sammons Financial Group Companies; Sioux Falls (SD); On-site; USD 38,000 - 71,000; Full time

Benefits offered by this job

Health coverage

ESOP

401(k)

Paid time off

Friday afternoons off

Job summary

Sammons Financial Group Companies is seeking a Claims professional to review requirements, determine coverage, and finalize settlements in alignment with policy provisions and regulatory standards.

The role emphasizes accurate data review, written and verbal communication with agents and beneficiaries, and adherence to service level agreements. Prior claims experience and strong organizational skills are desired.

Qualifications

• Bachelor's degree preferred and insurance/annuity/life claim experience is valued.
• Ability to communicate effectively and tactfully with agents, policyholders, beneficiaries and staff.
• Proficiency with multiple information screens and standard tools used in claims.
• Previous customer service experience is preferred.

Responsibilities

• Request and review claims requirements to determine coverage and settlements.
• Ensure settlements meet SLA and quality standards and regulatory requirements.
• Gather medical records, legal documents, and policy data to determine coverage.
• Escalate complex requests to Manager or Legal Department as needed.
• Communicate with internal and external customers by writing and calling.
• Balance department accounts monthly and maintain controls.

Skills

Communication skills

Organizational skills

Attention to detail

Customer service

Education

Bachelor's degree preferred

Tools

MS Office

Job description

Sammons Financial Group Companies is seeking a Claims professional to review requirements, determine coverage, and finalize settlements in alignment with policy provisions and regulatory standards.

The role emphasizes accurate data review, written and verbal communication with agents and beneficiaries, and adherence to service level agreements. Prior claims experience and strong organizational skills are desired.