At Globe Life, we are committed to empowering our employees with the support and opportunities they need to succeed at every stage of their career. We take pride in fostering a caring and innovative culture that enables us to collectively grow and overcome challenges in a connected, collaborative, and mutually respectful environment that calls us to help Make Tomorrow Better.
Role Overview:
Could you be our next Claims Handling Representative? Globe Life is looking for a Claims Handling Representative to join the team!
The role is responsible for the prompt and accurate processing of supplemental accident and health claims within established deadlines, while adhering to department procedures and guidelines to ensure compliance with HIPAA, insurance laws and regulations, and state-specific policy and benefit contract provisions. The position involves reviewing medical records and documentation to analyze and apply policy benefits, limitations, and exclusions, as well as maintaining phone correspondence with medical facilities, providers, policyholders, and agents. Additionally, this role supports various department functions, projects, and assignments as directed.
This is a remote/work-from-home position.
What You Will Do:
- Process all health and accident claims promptly and daily by required deadlines, including reviewing claims documents, medical records, provider bills, receipts, and invoices to apply or deny benefits.
- Ensure claims are processed accurately and in accordance with company guidelines, department policies and operating procedures, and in compliance with HIPAA, insurance laws and regulations, and state-specific policy and benefit contract provisions.
- Contact medical facilities, providers, legal entities, policyholders, and agents to obtain necessary documents required to process claims.
- Apply knowledge of underwriting health questions and medical terminology related to policy applications, waiting periods, and pre-existing conditions.
- Review system notes and documents to thoroughly explain and provide details on claims status, benefit payments, denials, appeal decisions, and any information needed for pending claims.
- Handle customer and agent inquiries, issues, and complaints with timely research, follow-up, and resolution in a professional and courteous manner.
- Ensure customer and agent needs are met on every interaction, and document all phone calls, issues, and correspondence in system notes and the claim file.
- Meet quality assurance requirements, key performance metrics, and productivity standards.
- Cross-train with other operational departments on functions that affect claims, including premium deductions, multiple policy limits, cash value, return of premium, and money-back maturity processes.
- Create written correspondence to clearly communicate with policyholders, including special letters as needed, and complete authorization forms for new claims and medical records requests.
- Research and correct claims processing errors in a timely manner.
- Process and respond promptly to miscellaneous customer and agent requests, including mailing of claim forms, information release authorization testimonials, itemized benefits lists, faxes, and issuing of duplicate policies.
- Communicate pertinent information or issues promptly to the Team Leader, Supervisor, and/or Manager.
- Identify and recommend areas of improvement for processes, procedures, and system enhancements.
- Develop an understanding of the processes within the Underwriting, Customer Service, Billing, and Corporate Services departments.
- Complete training as required by auditors, compliance teams, and state regulations.
- Assist with various department functions, projects, and assignments as directed.
What You Can Bring:
- High School Diploma or equivalent.
- Minimum of 3–5 years of prior phone, customer service, and office experience.
- Previous experience in a claims service environment preferred; medical terminology or medical office background desirable.
- Bilingual skills a plus.
- High level of quality focus on providing excellent customer service with the ability to process a high volume of claims efficiently and accurately.
- Critical problem-solving, decision-making, and analytical skills with strong attention to detail.
- Excellent verbal, written, and communication skills with strong organizational and research abilities.
- Ability to work well under pressure, manage multiple tasks with competing deadlines, both independently and as a team player.
Applicable To All Employees of Globe Life Family of Companies:
Reliable and predictable attendance of your assigned shift.
Ability to work full time and/or part time based on the position specifications.
How Globe Life Will Support You:
Looking to continue your career in an environment that values your contribution and invests in your growth? We've curated a benefits package that helps to ensure that you don’t just work, but thrive at Globe Life:
Competitive compensation designed to reflect your expertise and contribution.
Comprehensive health, dental, and vision insurance plans because your well-being is fundamental to your performance.
Robust life insurance benefits and retirement plans, including company-matched 401k and pension plan.
Paid holidays and time off to support a healthy work-life balance.
Parental leave to help our employees welcome their new additions.
Subsidized all-in-one subscriptions to support your fitness, mindfulness, nutrition, and sleep goals.
Company-paid counseling for assistance with mental health, stress management, and work-life balance.
Continued education reimbursement eligibility and company-paid FLMI and ICA courses to grow your career.
Discounted Texas Rangers tickets for a proud visit to Globe Life Field.
Opportunity awaits! Invest in your professional legacy, realize your path, and see the direct impact you can make in a workplace that celebrates and harnesses your unique talents and perspectives to their fullest potential. At Globe Life, your voice matters.
