Life Claims Consultant

At Northwestern Mutual, we are strong, innovative and growing. We invest in our people. We care and make a positive difference.

Summary :

The Life Claims Consultant is responsible for assessing and making decisions on life insurance claims, including high-value and suspicious cases, ensuring compliance with a $5M signature authority limit. This role involves analyzing various documents such as death certificates, claim forms, legal documentation, and conducting routine reviews of contestable claims in accordance with contract language and state laws. You'll provide direction on complex claim referrals, collaborating with various departments such as Law, Underwriting, and Special Investigations. You must clearly communicate claims decisions and handle disputes or appeals on complex claims, collaborating with legal counsel and participate in depositions as necessary.

Primary Duties & Responsibilities :

Decision Making and Claims Review

• Preserve Northwestern Mutual's image and reputation in making benefit decisions despite difficult and emotional circumstances.
• Make fair, accurate, and timely decisions on life insurance claims, involving high value policies, suspicious circumstances, and / or newly issued policies within the contestable period, all while maintaining compliance with a $5M signature authority limit.
• Examine and analyze claim information, including beneficiary data, policy values, death certificates, claim forms, assignment forms, divorce decrees, and estate and trust documentation, and other relevant documents.
• Conduct routine contestable claim reviews in accordance with applicable contract language and state laws. Frequently review medical records, pharmacy reports, police reports, medical examiner reports, policy applications, and underwriting assessments.
• Communicate claims decisions to beneficiaries and other parties clearly and sensitively, providing detailed explanations and supporting documentation as needed, often in written form.
• Manage and resolve disputes or appeals related to claims decisions with legal counsel and be prepared to represent the company in legal matters, including depositions and trials.
• Exhibit empathy, professionalism, and tact in all interactions, especially with sensitive or contentious claims.
• Manage phone and transactional responsibilities with a strong commitment to confidentiality.
• Maintain organization, accuracy, and timeliness in case management systems; accurately capture and document claim-related information and / or refer tasks as appropriate.
• Ensure efficiency and accuracy by maintaining production and claim quality standards.
• Facilitate internal and external claim audits as necessary.

Leadership and Collaboration

Qualifications :

Desired Skills :

This position has been classified as an Associated Person under NMIS guidelines and requires fingerprinting and completion of required form.

Compensation Range :

Pay Range - Start : $64,820.00

Pay Range - End : $120,380.00

Northwestern Mutual pays on a geographic-specific salary structure and placement in the salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity as well as the cost of labor in the market; and other conditions of employment. At Northwestern Mutual, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. Please note that the salary range listed in the posting is the standard pay structure. Positions in certain locations (such as California) may provide an increase on the standard pay structure based on the location. Please click here for additional information relating to location-based pay structures.

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We are an equal opportunity / affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender identity or expression, sexual orientation, national origin, disability, age or status as a protected veteran, or any other characteristic protected by law.

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