Accident & Health Claims Auditor: Analyze & Resolve Complex Claims

One80 Intermediaries; Oregon; Hybrid; USD 28,000 - 30,000; Full time

Benefits offered by this job

Health benefits

401k plan

Student Loan Assistance

Tuition Reimbursement

Mental Health & Wellness

Job summary

One80 Intermediaries is seeking an Accident and Health Claims Auditor to join our growing team. You will analyze, review, and process claims ensuring adherence to policy provisions and documentation standards.

You will handle moderate to complex issues, obtain necessary documents, and release accurate benefit payments. Excellent communication and MS Office skills are required. This role is based in Oregon and offers comprehensive benefits.

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.
• 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

Communication

Microsoft Office

Independent work

Education

High School Diploma

Job description

One80 Intermediaries is seeking an Accident and Health Claims Auditor to join our growing team. You will analyze, review, and process claims ensuring adherence to policy provisions and documentation standards.

You will handle moderate to complex issues, obtain necessary documents, and release accurate benefit payments. Excellent communication and MS Office skills are required. This role is based in Oregon and offers comprehensive benefits.