Sr. Claims Support Analyst - Quality at AAA Life Insurance Company — Remote, USA | Base Career

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AAA Life is a respected and trusted American brand that has been focusing on Life Insurance and Annuity Products since 1969.

At AAA Life we have over 1.8 million policies where we take pride in earning the trust of our policyholders who understand our promise to be there for them – and their families – when we’re needed most.

By joining the AAA Life team, you are joining a company that genuinely cares about helping each other, with a devotion to protect the lives of those around us.

We embrace a diverse, equitable, inclusive culture where all associates can feel a sense of belonging and use their unique talents and perspective to influence, innovate, motivate, and thrive.

Operating within the core values and operating principles of the organization, supports the operations of the Claims Department. The Senior Claims Support Analyst conducts various quality audits of all claim types, including complex claims, administrative functions, and phone calls to ensure that we are meeting our regulatory obligations and adhering to departmental procedures. Oversees the Claims quality program through developing and maintaining the process review criteria, establishing sample size and recommending approval authority changes to management, training the Claims Support Analyst on call monitoring and claim auditing techniques, identifies, trends, communicates and coaches claims staff on key quality development opportunities.

Relocation Eligibility: Not Available

Performs quality audits for all types of claims including Life, Annuity, and A&H to ensure regulatory compliance and adherence to our internal processes and procedures.
Develops and provides reports to management. Delivers developmental feedback and coaching to claims staff as needed.
Reviews regulatory changes from compliance, updates procedure documents and communicates changes to staff. Updates quality audit process to ensure compliance.
Develops and maintains audit review criteria. Establishes sample size for process and telephone call audits.
Recommends changes in examiner approval authority for claim decision audits.
Provides secondary signoff on claims within scope of authority following completion of all claim decision audits (payments and denials).

Demonstrates significant knowledge and understanding of insurance contracts, reinsurance, MIB, medical impairments, financial documents, and tools used to investigate and resolve claims.
Demonstrates significant knowledge regarding legal aspects and statutory guidelines including fair claims practices, HIPAA, Privacy and ACLI Guidelines.
Proficient using internet based applications and Microsoft office products, specifically Word, Excel, and Powerpoint.
Able to perform basic mathematical calculations to include addition, subtraction, multiplication, division, and percentage.
Able to work hours as required by business needs (may include flex scheduling, irregular hours, weekends, and holidays).
Ability to establish and maintain effective professional relationships.
Ability to perform and/or coordinate the completion of multiple simultaneous projects in a fast-paced environment while maintaining deadlines.
Extremely well organized, project management orientation
Self-motivated, ability to work in a team environment and autonomously

While performing the duties of this job, the employee is frequently required to stand, walk, sit, use hands to finger, handle, or feel, talk, hear and concentrate.

Specific vision abilities required by this job include close vision, distance vision, depth perception, and ability to adjust focus.

This job requires the ability to perform duties contained in the job description for this position, including, but not limited to, the above requirements.

Reasonable accommodation will be made for otherwise qualified applicants as needed to enable them to fulfill these requirements.

We are committed to ensuring equal employment opportunities for all job applicants and employees.

Employment decisions are based upon job-related reasons regardless of an applicant's race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability, marital status, genetic information, protected veteran status, or any other status protected by law.

AAA Life Insurance Company does not offer immigration sponsorship for this position.

This includes visa types such as H-1B, TN, and STEM OPT.

Please do not apply if you currently require or may require employer-sponsored immigration support now or in the future .

Sr. Claims Support Analyst - Quality

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Relocation Eligibility: Not Available

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