Business Segment: Capital North America Life & Health
Location(s): United States; Kansas; Overland Park
About Us: GE is the world’s Digital Industrial Company, transforming industry with software-defined machines and solutions that are connected, responsive and predictive. Through our people, leadership development, services, technology and scale, GE delivers better outcomes for global customers by speaking the language of industry. GE offers a great work environment, professional development, challenging careers, and competitive compensation. GE is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status or other characteristics protected by law.
Role Summary: Responsible for the processing and/or adjudication of Long Term Care (LTC) reinsurance claims, the execution of claim audits, consultation with other functions and clients, process performance metrics and management of claim reporting.
Essential Responsibilities: Reviews, adjudicates, and approves reinsurance claims. Completes process, desk and/or field claim audits. Provides ongoing input and advice to clients on claim investigation, evaluation and payment. Creates, enhances and updates claim metrics and operation performance reviews. Produces, analyzes and acts on claim management reports and measures. Tracks and reports on claim changes, issues and trends. Helps identify process improvement and works with IT to explore system solutions. Coordinates efforts with broader claims team as well as other organization functions. Travel 20% for audits.
Qualifications/Requirements: High School Diploma or GED. Minimum seven years (7) of insurance and/or reinsurance claims experience. Experience analyzing, interpreting, and applying insurance contracts and reinsurance treaties to claim situations. Experience working with insurance policy features, benefit requirements and limitations. Experience working with medical terminology and medical conditions generally, and as they relate to life and health claims. Eligibility Qualifications: Must submit application for employment through COS (internal candidates) or www.gecareers.com (external candidates) to be considered for this position. Legal authorization to work in the U.S. is required. We will not sponsor individuals for employment visas, now or in the future, for this job opening. Must be willing to comply with pre-employment screening, including but not limited to, drug testing, reference verification and background check. Must be willing to travel minimum 20%.
Desired Characteristics: Bachelor's degree in business, management or insurance. Reinsurance claim experience preferred. Long Term Care claims experience strongly preferred. FLMI, ALCH and other insurance designations a plus. Strong organization skills for planning and executing claim adjudication and audit responsibilities. Critical thinking skills that enable the identification and resolution of claim issues. Ability to organize, analyze and present data effectively. Reliable, self-starter and able to work effectively across functional boundaries. Strong written and oral communication skills.
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