Texas Claims Adjudicator

National Guardian Life Insurance Company; Madison (WI); Hybrid; USD 52,000 - 76,000; Full time

Benefits offered by this job

Paid Time Off

Company Holidays

Health/Dental/Vision

Health Savings Account

Annual Bonus

Parental Leave

401(k) Match

Sabbatical after 8 years

Paid Volunteer Time

Education Assistance

Employee Recognition

Job summary

National Guardian Life Insurance Company (NGL) is seeking a Claims Adjudicator to join our team in Madison. This role processes claims, communicates with policyholders, agents, funeral homes, and beneficiaries, and ensures timely, accurate adjudication under standard procedures.

You will handle diverse claim types including life, annuities, preneed, and rider claims, while documenting findings and maintaining service goals. A collaborative, empathetic approach is essential.

Qualifications

• Minimum: High School or GED.
• LOMA Level I Certificate preferred.
• LOMA ACS preferred.
• Wisconsin Preneed Certification preferred.
• One year claims processing experience or equivalent.

Responsibilities

• Accurately adjudicate claims within stated service goals.
• Verify forms and enter life insurance and annuity claims.
• Provide phone support and respond to customer inquiries.
• Research insured status and document findings.
• Collaborate with team to meet deadlines and standards.

Skills

Claims processing

Customer service

Communication skills

Data entry

Teamwork

Education

High School diploma or GED

LOMA Level I Certificate

LOMA ACS

Wisconsin Preneed Certification

Job description

We are adding a Claims Adjudicator to our team!

Who We Are:

Since 1909, National Guardian Life Insurance Company (NGL) has been one of America’s most successful and highly rated independent life insurance companies. We specialize in a suite of innovative products for life’s journey, giving people the financial stability, careful guidance and peace of mind to lead a life filled with confidence, dignity and grace.

NGL's Core Values – integrity, dependability, collaboration, compassion and growth are a foundation of our company and help to build on the interactions we have with our policyholders, partners, funeral homes and each other. We believe in creating an inclusive, welcoming environment for all where diversity is celebrated, and everyone is encouraged to live their best, most authentic self. We offer Employee Resource Groups for employees to get involved, learn, network, and offer professional and personal development opportunities.

With over 100 years of experience, our passion is to serve people. Learn more.

Work Environment:

NGL offers a flexible work environment where employees can work fully remote, hybrid or onsite at our Madison, Wis. office. We support virtual working arrangements in certain states outside of WI.

A Day in the Life:

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.

Primary Responsibilities:

• Accurately adjudicate claims within stated service goals.
  • Follow established written processing procedures
  • Verify proper forms are received according to state regulation
  • Accurately enter and process:
    • Whole life
    • Term Life
    • Universal life & Interest sensitive
    • Acquisition Preneed
    • Final Expense
    • Preneed
    • Trust claims including Tru Trust, NGL Funeral Expense Trust, and NGL Estate Planning Trust
    • Preneed Texas including accurate reconciliation and file documentation verification.
    • Annuities
    • Contestable claims including referring claims to Underwriting as needed.
    • Rider claims including accidental death, child/family rider, and spouse rider.
  • Accurately calculate cost basis on basic annuity claims
  • Follow-up timely on all claims in writing within state regulated time frames
• Provide phone support for all claims related calls and letter correspondence
  • Ability to effectively communicate, with empathy when appropriate, to our customers verbally, in writing, and via email
  • Ability to actively listen and appropriately respond to others
  • Provide phone support for claims related calls while maintaining team service goals
  • Contact agents, funeral homes beneficiaries, and other customers to obtain missing information when needed
  • Prepare proper correspondence for all steps in the claim process and as needed to respond to customer inquires
• Team Work
  • Ability and willingness to work with others in a team environment
  • Participate in group decision making, listening, and responding constructively to others
  • Offer help to teammates when the need arises
  • Manage and adjust personal time off, breaks, and lunches to insure sufficient team coverage
  • Help ensure that team standards and goals are maintained
• Problem Solve
  • Transfer knowledge from one process and apply it to another like process regarding common situations
  • Able to gather most needed data and petition input to help recognize the symptoms and root causes of distinct problems
  • Examine defined issues with ambiguous causes
  • Suggest alternative approaches that meet the needs or the organization, the situation, and those involved
  • Resolve difficulties and elevate issues with suggestions for additional inquiry
• Accurately research insured status
  • Follow established written processing procedures
  • Search databases to confirm Insured status
  • Update spreadsheets and document appropriately
• Complete assigned projects, tasks, and/or milestones by agreed upon due dates including performing other related work as requested or required

Essential to Your Success:

• 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

Education Requirements:

• Minimum: High School or GED
• Preferred: Other
  • LOMA Level I Certificate
  • LOMA ACS
  • Wisconsin Preneed Certification

Years of Experience:

• One year claims processing experience or equivalent business experience.
• Two years customer service or insurance/financial experience preferred.

What We Offer:

At NGL, we provide a comprehensive Total Rewards package that includes competitive base pay and benefits designed to offer solutions to help meet your unique life needs.

Benefits:

• 20 days of Paid Time Off growing to 25 days after 5 years
• 11 Paid Holidays (10 company holidays and 1 personal holiday of your choice)
• Health care, dental and vision plans
• Up to $1,500 (Family) or $1,000 (Single) annually towards a Health Savings Account
• Annual bonus based on company performance
• Paid Parental Leave
• 401(k) match up to 9%
• Paid Sabbatical after 8 years
• Paid Volunteer Time
• Education Assistance Program
• Employee Recognition Program
• And much more!

NGL is committed to creating a diverse environment and is an Equal Opportunity Employer. Qualified applicants will be considered for employment without regard to race, color, creed, religion, national origin, ancestry, citizenship status, age, disability, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws.

NGL is committed to providing reasonable accommodations to qualified individuals with disabilities in the recruitment process. To request an accommodation, please contact [e-mail].