Senior Claims Specialist

We are adding a Senior Claims Specialist to our team!

Since 1909, National Guardian Life Insurance Company (NGL) has been one of America’s most successful and highly rated independent life insurance companies. We specialize in a suite of innovative products for life’s journey, giving people the financial stability, careful guidance and peace of mind to lead a life filled with confidence, dignity and grace.

NGL's Core Values – integrity, dependability, collaboration, compassion and growth are a foundation of our company and help to build on the interactions we have with our policyholders, partners, funeral homes and each other. We believe in creating an inclusive, welcoming environment for all where diversity is celebrated, and everyone is encouraged to live their best, most authentic self. We offer Employee Resource Groups for employees to get involved, learn, network, and offer professional and personal development opportunities.

With over 100 years of experience, our passion is to serve people. Learn more.

NGL offers a flexible work environment where employees can work fully remote, hybrid or onsite at our Madison, Wis. office. We support virtual working arrangements in certain states outside of WI.

The Senior Claims Specialist is responsible for representing the Claims department on projects and recommending improvements to enhance cross-functional processes to drive efficiency and effectiveness. The Senior Claims Specialist effectively communicates and corresponds with external and internal customers including policyholders, agents, funeral directors, beneficiaries, physicians, and employers. Additionally, this role is responsible for completing recurring audits, assisting with written procedure maintenance, processing escalated or complex claims for various product lines/states, and additional projects as assigned.

This position provides guidance to team members, assists with training and resolves escalated claims. In this role, work is performed under minimal supervision.

• Actively participate and represent team in project meetings and in collaboration with the Claims Quality Assurance Analyst.
• Provide updates to various team participants and manager.
• Meet completion dates and assigned tasks.
• Research and provide in-depth and reliable information to project members.
• Complete any related system testing.
• Assist with reoccurring items including tax-related processes.
• Recommend and assist in implementing process improvements.
• Proactively identify, investigate, and provide solutions within team areas.
• Seek out information to enhance cross functional processes.
• Collaborate with other teams to ensure efficiency and effectiveness.

• Actively participant in group decision making, listening, and responding constructively to others.
• Serve as a back‑up trainer to new and existing staff on claims adjudication and changes to existing processes.
• Ensure work performed by others is done in accordance with policy and organizational guidelines and within stated service‑level agreements.
• Accurately adjudicate claims with high accuracy within defined service timelines as needed.
• Provide timely updates and issues to Team Lead or Manager as needed.
• Ensure Standard Operating Procedures are updated in collaboration with the Claims Quality Assurance Analyst, are available and disbursed to the team and others affected on agreed upon due dates.
• Provide guidance to teammates when needed in a constructive and professional manner.
• Resolve recurring accounting issues as needed.
• Assemble impromptu team meetings to discuss and prioritize work.
• Assist Team Lead in the monitoring of work distribution and turn‑around times.
• Manage and adjust breaks and lunches to ensure sufficient team coverage.

• Provide guidance and resolve complex claims for all product lines and from the state of Texas.
• Apply various problem‑solving methods and tools to analyze/solve process, procedural, and system problems.
• Determine the cause of problems and formulate solutions by testing them as possible for justification and plausibility.
• Examine…