Claims Analyst I

Allied National; Rockford (IL); On-site; USD 40,000 - 56,000; Full time

Job summary

Allied National is expanding its Claims team and seeking a Claims Analyst I to support our customers by learning our Claims Processing system, understanding benefit structures and basic policy provisions in Certificates of Insurance. The analyst will learn to convey decisions via written and phone communications with agents, insureds, providers, and other external customers.

Responsibilities include entering data from claims, reviewing and processing claims within established guidelines, and

Qualifications

• High school diploma or equivalent required.
• At least 1 year of office and telephone customer service experience required.
• Medical claims processing experience is a plus.

Responsibilities

• Enter data from claims into the system following departmental standards.
• Review and process claims within guidelines.
• Learn and apply claims procedures, benefit structures and policy provisions to determine payability, needed info, or denial.

Skills

Customer service

Office procedures

Telephone etiquette

Education

High school diploma

Job description

Description

Allied is excited to announce our Claims team is growing! We are looking forward to bringing on additional Analysts who are excited to support our customers. The Claims Analyst I is responsible for learning Allied's Claims Processing system, the benefit structures and basic policy provisions in the Certificates of Insurance. The Claims Analyst will also be responsible for making appropriate decisions on the claims reviewed and to convey this information through written or phone communications with agents, insureds, providers, and other external customers.

Responsibilities Include

• Enter data obtained from claims correspondence into the computer system, meeting departmental standards.
• Review and process claims within established department guidelines and standards.
• Be knowledgeable of all claims procedures, benefit structures, basic policy provisions, guidelines, state riders, telephone procedures and equipment through initial and ongoing training.
• Process different types of claims within established department guidelines and standards by visually reviewing the claims and applying all Policy provisions to determine if claim is payable, if additional information is needed, or if claim should be denied.

Requirements

• Must have a high school diploma or equivalent
• One year of office and telephone customer service experience is required
• Medical claims processing experience is a plus