Absence Management Specialist

Matrix Absence Management, Inc.; United States; Hybrid; USD 43,000 - 53,000; Full time

Benefits offered by this job

Annual performance bonus

401(k) company match

Medical plans

Health Savings Account

Dental and vision

Life & Disability Insurance

Parental Leave & Adoption Assistance

Hybrid work arrangements

Tuition Reimbursement

Paid Time Off

Volunteer days

Employee Resource Group

Job summary

Reliance Matrix is seeking a Claims Examiner in the United States to serve as a liaison among clients, claimants, and healthcare providers. You will apply claims management, interpret contract provisions, and ensure accurate coding and timely claim transitions.

The role emphasizes compliance, confidentiality, and delivering reliable service while meeting performance targets. Responsibilities include investigation of issues, collaboration with departments, and ongoing training to stay current

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.
• 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.

Responsibilities

• Acts as a liaison between client, employee and healthcare provider.
• Applies appropriate claims management by providing reliable and responsive service to claimants and clients.
• Investigates claim issues providing resolution within guidelines.
• Interprets and administers contract provisions: eligibility and duration.
• Codes all system fields with correct financial, diagnosis and duration information.
• Coordinates with other departments to ensure claims transition or timely return to work.
• Maintains compliance with procedures and Unfair Claims Practice regulations.
• Manages Performance Guarantee clients and meets metrics.
• Maintains confidentiality and HIPAA compliance.

Skills

Attention to detail

Analytical skills

Customer service

Written communication

Verbal communication

Education

High School Diploma

Bachelor's degree preferred

Tools

Microsoft Office

Job description

Job Responsibilities and Requirements

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. Description of responsibilities: 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.

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.

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. Work location may be flexible if approved by the Company.

What We Offer

At Reliance Matrix, we believe that fostering an inclusive culture allows us to realize more of our potential. And we can’t do this without our most important asset—you. That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing.

• An annual performance bonus for all team members


• Generous 401(k) company match that is immediately vested


• A choice of three medical plans (that include 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 to ensure financial protection when you need it most


• 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

Our Values

Integrity

Empowerment

Compassion

Collaboration

Fun

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.

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