Claims Specialist

About the Role

The AICK Claims Specialist is responsible for reviewing, investigating, and making decisions on a wide range of claims for products marketed by AICK. This includes claims related to Waiver of Premium, Term Life, Accidental Death & Dismemberment, Short Term Disability, Long Term Disability, Living Benefit Rider, Ordinary Life, Yearly Renewable Term, and all Voluntary Life and Accidental Death & Dismemberment coverage. The role also contributes to new product development, responds to questions about policy administration, and may represent AICK on ad hoc teams as needed.

This position can be performed in a hybrid or onsite arrangement in line with the telecommuting policy. Applicants must live in Kansas or Missouri, or be willing to relocate as a condition of employment.

Why This Opportunity Stands Out

• Your work will directly support the health and well-being of Kansans.
• The organization offers a family-first total rewards approach, including paid vacation, sick leave, and paid maternity and paternity leave available immediately after hire.
• There are ongoing training and development opportunities for professional growth.
• You will join a collaborative team in a flexible work environment.
• The company has more than 80 years of service built on trust, compassion, and community.
• The workplace is designed to be inclusive, respectful, and value every employee.

Benefits and Perks

• Competitive total rewards package, with base pay as only one part of the overall offering.
• Incentive pay program (EPIP).
• Medical, vision, and dental insurance.
• Six weeks of paid parental leave for new mothers and fathers.
• Fertility and adoption assistance.
• Two weeks of paid caregiver leave.
• 401(k) matching up to 5%.
• Tuition reimbursement.
• Health and fitness benefits, discounts, and resources.

Key Responsibilities

• Review, investigate, and decide claims by verifying eligibility, coverage, and contract terms, while gathering supporting information from employers, hospitals, reinsurers, and other external partners.
• Ensure claims are handled in line with ERISA, NAIC unfair claims practices standards, and applicable state regulations, and completed within required statutory timelines with proper documentation.
• Interpret policy language, reinsurance treaties, and group contracts to determine claim payment responsibility, reinsurer liability, and continuation of liability, while coordinating determinations with reinsurers.
• Perform detailed investigations on complex or questionable claims, work with investigators or rehabilitation specialists, and prepare documentation for possible legal action when needed.
• Administer the disability claim lifecycle, including continuance reviews, treatment plan evaluation, and assessment of rehabilitation or return-to-work options.
• Explain claim outcomes and policy terms clearly to claimants, employers, attorneys, and regulators through phone calls and written communication, including denials and inquiries.
• Handle overpayment recovery and collection efforts, including setting up and monitoring repayment arrangements with claimants.
• Keep claim records and systems accurate by reviewing reports, reconciling balances, making adjustments, and approving claims for payment according to guidelines.
• Research and respond to complaints from the State Insurance Department, take corrective action when necessary, and maintain complaint logs to meet compliance standards.
• Assist with contract changes and product development by working across teams, participating in ad hoc groups, and spotting process or compliance improvements.
• Prepare and report financial and operational data, including Schedule F for the Annual Statement, management reporting such as claim processing time, paid claims, and closed claims, plus required filings such as FICA and W-2/W-3.
• Take part in testing claims payment systems, including confirming new releases and defect corrections.

Knowledge and Skills Needed

The ideal candidate can evaluate detailed contract language and make sound decisions based on facts and defined criteria. Strong written and verbal communication skills are essential, along with the ability to work through complex claim scenarios accurately and in compliance with rules and procedures.

Additional Information

This role is based in Topeka, Kansas. The organization emphasizes trust, stability, inclusion, and service to the community. No vacancy count, compensation amount, or application deadline was provided in the source.