Absence Management Specialist

Matrix Absence Management, Inc.; Oregon (WI); Hybrid; USD 27,276 - 38,848; Part time

Benefits offered by this job

Annual performance bonus

Generous 401(k) match

Medical plan options

Paid Time Off

Tuition Reimbursement

Job summary

Matrix Absence Management, Inc. is seeking a Claims Examiner to manage claims and act as a liaison between the client, employee, and healthcare provider. Responsibilities include investigating claim issues, administering contract provisions, and maintaining compliance.

The ideal candidate will have a strong attention to detail, organizational skills, and be proficient in Microsoft Office. The hourly pay starts at $24, with various benefits including a generous 401(k) match and Paid Time Off.

Qualifications

• Ability to develop proficiency regarding required RSL products and systems.
• Strong ability to prioritize work and multi-task.
• Collaboration with others while also working independently.

Responsibilities

• Act as a liaison between client, employee, and healthcare provider.
• Investigate claim issues providing resolution.
• Interpret and administer contract provisions: eligibility and duration.
• Accurately code all system fields with correct financial information.
• Coordinate with other departments for claims transition.
• Maintain compliance with departmental procedures.

Skills

Attention to detail

Analytical skills

Organizational skills

Microsoft Office experience

Customer service orientation

Written communication skills

Verbal communication skills

Education

High School Diploma or GED (Bachelor’s preferred)

Job description

Job Responsibilities

The Claims Examiner will act as a liaison between client, employee and healthcare provider. In this position, you are responsible for applying appropriate claims management by providing reliable and responsive service to claimants and clients.

• Investigates claim issues providing resolution within departmental and regulatory guidelines.
• Interprets and administers contract provisions: eligibility and duration.
• Accurately codes all system fields with correct financial, diagnosis and duration information.
• Coordinates with other departments to ensure appropriate claims transition or facilitate timely return to work.
• Adheres to compliance, departmental procedures, and Unfair Claims Practice regulations.
• Actively contributes to customer service, quality and performance objectives.
• Proactively engages in departmental training to remain current with all claim management practices.
• Responsible for managing Performance Guarantee clients and meet targeted metrics.
• Responsible and accountable for maintaining and protecting personal health information.
• Must maintain a high level of confidentiality and abide by HIPPA rules and regulations.

Work location may be flexible if approved by the Company.

Qualifications

• High School Diploma or GED (Bachelor’s preferred).
• Ability to develop proficiency regarding required RSL products, systems and processes related to the effective delivery of new business proposals.
• Microsoft Office experience.
• Attention to detail, analytical skills, and the ability to collaborate with others and work independently.
• Strong organizational skills, including the ability to prioritize work and multi-task.
• Customer service experience and orientation.
• Written and verbal communication skills.

Compensation

The expected hiring range for this position is $24.00 hourly. This expected hiring range covers only base pay and excludes any other compensation components such as commissions or incentive awards. The successful candidate’s starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions. These ranges may be modified in the future.

Benefits

• Annual performance bonus for all team members.
• Generous 401(k) company match that is immediately vested.
• Choice of three medical plans (including prescription drug coverage) to suit your unique needs.
• For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account.
• Multiple options for dental and vision coverage.
• Company provided Life & Disability Insurance.
• Family friendly benefits including Paid Parental Leave & Adoption Assistance.
• Hybrid work arrangements for eligible roles.
• Tuition Reimbursement and Continuing Professional Education.
• Paid Time Off – new hires start with at least 20 days of PTO per year in addition to nine company paid holidays. As you grow with us, your PTO may increase based on your level within the company and years of service.
• Volunteer days, community partnerships, and Employee Assistance Program.
• Ability to connect with colleagues around the country through our Employee Resource Group program.

EEO Statement

Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications.