Accident & Health Claims Specialist

One80 Intermediaries; United States; À distance; USD 25 000 - 26 000; Plein temps

Avantages offerts par ce poste

Health benefits

401k

Employee discounts

Tuition reimbursement

Paid time off

Flexible holidays

Résumé du poste

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.

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.

Responsabilités

• 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.

Connaissances

Interpersonal communication

Oral communication

Written communication

Microsoft Office

Formation

High School Diploma or equivalent

Outils

Microsoft Office

Description du poste

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.