Analytical Claims Auditor – Accident & Health

Brown & Brown; United States; On-site; USD 28,000 - 30,000; Full time

Benefits offered by this job

Health benefits: Medical, Dental, and?

401(k)

Student loan assistance

Tuition reimbursement

Mental health services

Job summary

One80 Intermediaries is seeking an Accident and Health Claims Auditor to join our growing team. You will review and analyze claims for accuracy based on policy provisions and ensure proper documentation is obtained.

You will handle moderate to complex issues and decide approval or denial within established guidelines. In this role, you will release accurate benefit payments, maintain documentation in the claims system, and assist with inbound calls as part of the CSR support, applying thorough

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

Independent work

Interpersonal skills

MS Office proficiency

Written communication

Education

High School Diploma or equivalent

Job description

One80 Intermediaries is seeking an Accident and Health Claims Auditor to join our growing team. You will review and analyze claims for accuracy based on policy provisions and ensure proper documentation is obtained.

You will handle moderate to complex issues and decide approval or denial within established guidelines. In this role, you will release accurate benefit payments, maintain documentation in the claims system, and assist with inbound calls as part of the CSR support, applying thorough