Key skills
Communication
About this role
Role Overview
- Examine routine and non-routine claims for one or more products and multiple series of contracts
- Analyze claims to determine benefit/contract eligibility
- Process claim transactions within specified dollar limits in compliance with regulatory standards
- Partner with members, financial associates, doctors, providers, attorneys, police, vendors and other customers regarding claims
- Participate in the development and implementation of business processes and standard operating procedures
- Provide consultation to Associate Claims Examiners on claims decisions
Requirements
- High school required
- College degree preferred
- Minimum of 2 years relevant experience
- Professional credentials preferred (e.g. LOMA, ICA)
- Intermediate knowledge of claim administration and operations as well as pertinent laws and regulations
- Must possess strong interpersonal skills, as well as excellent verbal and written communication skills
Benefits
- various bonuses (including, for example, annual or long-term incentives)
- medical, dental, and vision insurance
- health savings account
- flexible spending account
- 401k
- pension
- life and accidental death and dismemberment insurance
- disability insurance
- supplemental protection insurance
- 20 days of Paid Time Off each year
- Sick and Safe Time
- 10 paid company holidays
- Volunteer Time Off
- paid parental leave
- EAP
- well-being benefits
- other employee benefits