Accident and Health Claims Examiner

One80 Intermediaries Inc.; Clearwater (FL); On-site; USD 28,000 - 30,000; Full time

Benefits offered by this job

Health Benefits

401k

Student Loan Assistance

Tuition Reimbursement

Mental Health & Wellness

Job summary

One80 Intermediaries in Florida is seeking an Accident and Health Claims Examiner to join our growing team. You will review and analyze claims to ensure accurate processing according to policy provisions, and handle moderate to complex issues from intake to decision.

You will obtain necessary documentation, apply policy provisions, release accurate benefit payments, and document all actions in the claims system while coordinating with customers and internal teams.

Qualifications

• High School Diploma or equivalent.
• Ability to function independently within established guidelines.
• Excellent interpersonal, oral and written communication skills.
• Intermediate skill level in Microsoft Office programs.

Responsibilities

• Analyze and research claim issues of moderate to complex difficulty.
• Review workflows, policy certificates and policy provisions.
• Request and obtain necessary documents for claim processing and consideration.
• Release accurate benefit payments in accordance with CBP policy and agreements.
• Document follow-up information in the claim system.
• Handle inbound calls as part of the queue or CSR overflow.

Skills

Interpersonal communication

Written communication

Microsoft Office

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

**One80 Intermediaries** is seeking an **Accident and Health Claims Examiner**to join our growing team!In this role, you will be responsible for reviewing and analyzing claims to ensure they are processed accurately and in accordance with policy provisions. You will handle moderate to complex claim issues, ensuring that all necessary documentation is obtained, and claims are either approved or denied based on established guidelines.**How You Will Contribute:*** Analyze and research claim issues of moderate to complex difficulty.* Ability to comprehend complicated workflows, policy certificates, and policy provisions.* Review and apply policy provisions in processing of claims received.* Request and obtain necessary documents for claim processing/consideration, including scheduling follow-ups for documentation.* Release of accurate benefit payments in accordance with CBP policy, industry standard & other applicable TPA or SLA agreements.* Proper documentation of required information in claim system, including follow up information.* Receive inbound calls within assigned queues and/or as an overflow for the CSR team.**Skills & Experience to be Successful:*** High School Diploma or equivalent.* Ability to function independently within established guidelines.* Excellent interpersonal, oral and written communication skills.* Intermediate skill level in Microsoft Office programs.**About One80:**One80 Intermediaries is part of Arrowhead Intermediaries, a global insurance distribution platform that offers deep specialization, scale, and innovation across wholesale brokerage, program administration, and specialty insurance. With more than 7,000 professionals worldwide and a collective portfolio exceeding $18 billion in premium placed in 2024, our combined organization delivers a diverse trading platform for insurance carriers as well as expanded access and niche solutions for brokers and customers navigating complex and hard-to-place risks. The platform combines entrepreneurial culture with operational excellence to deliver tailored solutions and long-term value across the insurance ecosystem.**Pay Range**$20.00 - $22.00 Hourly*The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for the role.***Teammate Benefits & Total Well-Being**We go beyond standard benefits, focusing on the total well-being of our teammates, including:* *Health Benefits*: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance* *Financial Benefits*: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement* *Mental Health & Wellness*: Free Mental Health & Enhanced Advocacy Services* *Beyond Benefits*: Paid Time Off, Holidays, Preferred Partner Discounts and more.*Not reflective of all benefits. Enrollment waiting periods or eligibility criteria may apply to certain benefits. Benefit details and offerings may vary for subsidiary entities or in specific geographic locations.*