Claims Analyst jobs in Austin, TX

Committed to providing life insurance solutions since 1969 in the United States and globally since 1975, Citizens, Inc. is a publicly traded company (NYSE: CIA) that has maintained a listing on the New York Stock Exchange since 2002. Operating through our insurance subsidiaries, we strategically offer traditional insurance products in niche markets to capitalize on competitive advantages. With a dedicated team of employees located in Austin, Louisiana and a global network of agents, our reach extends to Latin America, Central America, and Asia.

THE OPPORTUNITY

Title: Domestic Claims Analyst I

Job Type: Full-time Non-exempt

Reports to: Rosalinda Sisson

Location: Austin, TX (Corporate Headquarters located in the Domain)

In Office

At Citizens, Inc., we've curated an exceptional work environment that goes beyond the ordinary. Our open-plan workspace offers panoramic views of the Domain with multiple conference rooms readily available. Start your day with complimentary coffee in our large break area, enjoy walks on the scenic trails nearby, or hit our onsite gym. Our Lunch Drop service provides the luxury of delivering delicious meals directly to our suite for a stress-free lunch break. For financial needs, the onsite bank is at your service. Furthermore, enjoy the convenience of free covered parking in our garage, featuring charging stations for electric vehicles. Participate in our various monthly employee events designed to enhance our cultural engagement. At Citizens Inc., we prioritize strong employee involvement to foster a dynamic workplace culture. Elevate your career with us, where your workplace is more than just an office; it's a destination for growth, innovation, and a flourishing community.

Summary: Citizens Inc. is looking for someone who has the ability to review proofs of loss quickly, ensure claims are administered in accordance with policy provisions and the company’s practices and philosophy, and work well with others.  This requires a detail-oriented mind set, critical thinker who is willing to take initiative and work consultatively with others. This person will work effectively and efficiently to meet expected turnaround times.  We look for our claim analysts to be analytical and provide prompt, fair payment of all legitimate claims.   

WHAT YOU WILL GET TO DO

Customer Service and Communication:

• Answer and respond to inbound telephone inquiries from policy beneficiaries or their representatives, and provide excellent service during their claims inquiries.
• Correspond with agents, policyholders, hospitals, doctors, attorneys, beneficiaries, and claimants for information regarding the claim.
• Correspond with customers for resolutions of concerns through outgoing calls or written communications.
• Maintain communication with management regarding developments within areas of assigned responsibilities and perform special projects as required or requested.
• Ability to develop and maintain positive working relationships with internal/external stakeholder.

Analytical and Decision-Making: 

• Review policy contracts and determine if coverage is applicable.
• Review and prepare claims for processing; update claims information in the claims application.
• Determine base payment by referring to policy coverage and limits, deciding on the course of action (payment, further investigation, or denial).
• Assess, research, and correct claims discrepancies, collaborating with other team members as needed.

Administrative and Process Management:

• Maintain claims information in the claims application.
• Maintain the assigned follow-ups and pending inventory.
• Process verifications and manage the verification inventory.
• Maintain complete confidentiality of company business.
• Participate in educational seminars, webinars, and local claims meetings.

Cross-Training and Skill Development: 

• Cross-train on various product processing within the claims department.
  1. Based on experience could be approved to release up to $1000 without secondary review
  2. Have release authority no more than $10,000
• Approval limit will vary with experience level, including release authority up to a certain amount. 

Performance Standards: 

• Ability to establish rapport and build relationships in a professional manner.
• Ability to address issues/concerns in a professional manner.
• Ability to operate in a fast-paced environment shaped by constant change and innovation.
• Ability to balance prompt claim settlement against the need to be accurate in determining liability for each claim.
• Comply with HIPAA and other privacy regulations.
• Meet the minimum qualitative standards for a Domestic Claims Analyst I 
  1. Financial accuracy: 99.5%
  2. Payment accuracy: 98%
  3. Procedural accuracy: 95%

WHAT YOU NEED TO SUCCEED 

• Bachelor’s degree preferred.  However, insurance related work experience and strong computer skills  acceptable.
• Courses in business, finance, economics and mathematics are particularly helpful.
• Complete LOMA 1 & 2 (280 & 290) courses, Associate, Customer Service (ACS) designation and working toward the Associate, Life & Health Claims designation (ALHC). 
• Associate, Life & Health Claims (ALHC) and Associate, Life Management Institute (ALMI) certifications are necessary for advancement to a claims manager position. 
• Skill in Microsoft Office products
• Excellent analytical, organizational and interpersonal skills
• Well-developed written and verbal communication skills
• Strong math and/or financial skills

BENEFITS (the fun stuff)

As an employee of Citizens, we promise you the opportunity to make a meaningful difference in the lives of our customers, communities, and one another. We believe in fostering a culture of camaraderie, where your ideas are valued, and collaborative efforts drive innovation. Our commitment to rewarding work extends beyond professional growth to recognize your individual contributions and achievements.

We take a complete approach to our employees' well-being. Our benefits package includes medical, dental, vision, short-term and long-term disability, AD&D, group term life insurance, and a matching 401k to secure your financial future. Our benefits plan allows for Virtual Visits and access to our Employee Assistance Program, showcasing our commitment to your health and work-life balance. Enjoy the added perks of generous Paid Time Off and holidays, ensuring you have the time to recharge and savor life outside of work. Join us and embrace a workplace that values not only your professional growth but also your personal fulfillment.

At Citizens, our employees and customers are at the heart of everything we do. Our success as a company begins with our team of employees and departments to service our customers. That's why we strive to create an environment where employees are equipped and challenged to reach their full potential.

Citizens is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, gender identity, national origin, age, disability, or veteran status. We are committed to fostering a diverse and inclusive workplace where every individual is valued, and all qualified applicants are encouraged to apply.