Claims Examiner

SUMMARY

This position is responsible for reviewing and processing Retirement, Death and Refund applications, supporting documents, data entry, determining eligibility, and calculating IMRF benefits. This position is responsible for using manual processing procedures to resolve most pending and work queue conditions. It is expected that this position can independently process all but the most complex manual claims. This position provides manual estimates and retirement information to members and the other Illinois Reciprocal Retirement Systems.

• Review and accurately input all information and supporting documentation, determine eligibility, and calculate retirement and death claims and voluntary additional benefits.
• Calculate and prepare manual benefit estimates.
• Contact other IMRF departments to obtain information, request corrections in an effort to resolve most internal conditions preventing payment of benefits.
• Contact employers, employees, beneficiaries, and financial institutions to resolve most external conditions preventing payment of benefits.
• Provide customer service to employers, employees, beneficiaries, and other IMRF departments by answering questions concerning procedures and benefits, either in writing or by telephone.
• Maintain a work in progress that meets service goals.
• Process Voluntary Additional Refund applications and Separation Refund applications as a back-up to the Staff Assistant as assigned.
• Review various internal reports including the suspended benefit report, the un-confirmed death report and the cash receipts report for items to be researched and resolved on a monthly basis.
• Other duties may be assigned.

This job has no supervisory responsibilities.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Associate's degree (AA) or equivalent from two-year college or technical school; or two years related experience and/or training; or equivalent combination of education and experience.

Ability to read, analyze, and interpret benefit claim forms, supporting documents, and written procedures. Ability to effectively prepare drafts of business correspondence. Ability to effectively communicate by telephone with internal and external customers to respond to questions and obtain needed information.

Ability to work with mathematical concepts such as benefit calculations, including use of the IMRF benefits formula tables. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit. The employee frequently is required to use hands to finger, handle, or feel. The employee is occasionally required to talk or hear. Specific vision abilities required by this job include close vision.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.

This position requires a person who is detail oriented and has strong customer service…