Accident and Health Claims Examiner

One80 Intermediaries; United States; A distancia; USD 25.000 - 26.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health benefits

401k

Employee discounts

Tuition reimbursement

Paid time off

Flexible holidays

Descripción de la vacante

One80 Intermediaries is seeking an Accident and Health Claims Examiner to review and analyze claims for accurate processing in line with policy provisions. You will handle moderate to complex issues, gather necessary documentation, and determine approvals or denials based on guidelines.

The role requires independent work within established guidelines, strong communication skills, and proficiency with Microsoft Office.

Formación

• 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.

Responsabilidades

• 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.

Conocimientos

Interpersonal communication

Oral communication

Written communication

Microsoft Office

Educación

High School Diploma or equivalent

Herramientas

Microsoft Office

Descripción del empleo

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers.

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

$18.00 - $19.00 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.

The Power To Be Yourself

As an Equal Opportunity Employer, we are committed to fostering an inclusive environment comprised of people from all backgrounds, with a variety of experiences and perspectives, guided by our Diversity, Inclusion & Belonging (DIB) motto, “The Power to Be Yourself”.