Claims Examiner (Remote)

Everett Agencies; Austin (TX); A distancia; USD 52.000 - 66.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health, dental, and vision insurance

Life insurance

Retirement plans

Paid holidays

Parental leave

Education reimbursement

Company-paid training/courses

Mental health support

Descripción de la vacante

American Income Life is seeking a Claims Examiner to evaluate eligibility, process and close claims with accuracy. You will interact with policyholders, agents and medical providers, handling communications via phone, email and written correspondence.

The role requires strong data entry and medical terminology knowledge, with the flexibility to work remotely. Qualified candidates bring a bachelor’s degree or 1–2 years of related experience, typing 50 wpm, and proficiency in Microsoft Office.

Formación

• Bachelor's degree or 1–2 years related experience and/or training, or an equivalent combination.
• Six months' experience in a Claims Department Data Entry & Mail Distribution representative role or four years in a non-entry level position.
• Typing 50 wpm minimum; knowledge of medical coding and terminology.
• Proficiency with Microsoft Office Suite at an advanced level.
• Strong arithmetic, organizational, and communication skills.
• Ability to work independently in a fast-paced environment.

Responsabilidades

• Evaluate claims to determine eligibility for benefits per policy contracts.
• Process claims according to procedures and complete accounting entries.
• Exercise independent action and judgment in claims decisions.
• Communicate with policyholders, agents, and medical providers via phone, email or written correspondence.
• Maintain high accuracy and assist with other duties as required.

Conocimientos

Typing 50 wpm

Medical terminology

Microsoft Office

Organizational skills

Written and verbal communication

Detail-oriented

Data entry

Insurance claims

Educación

Bachelor's degree

1–2 years related experience

High School diploma or equivalent

Herramientas

Excel

Outlook

Word

Descripción del empleo

At American Income Life, we are committed to empowering our employees with the support and opportunities they need to succeed at every stage of their career. We take pride in fostering a caring and innovative culture that enables us to collectively grow and overcome challenges in a connected, collaborative, and mutually respectful environment that calls us to Make Tomorrow Better.Role Overview:Could you be our next Claims Examiner? American Income Life is looking for a Claims Examiner to join the team!This role is responsible for the evaluation, investigation, benefit calculation, and processing of claims within the guidelines of policy contracts and Company procedures. The Claims Examiner plays a key role in ensuring accurate and timely claims processing while serving as a point of contact for policyholders, agents, and medical providers.This is a remote / work-from-home position.What You Will Do:Evaluate claims to determine eligibility for benefits in accordance with policy contracts.Process claims according to Company procedures and perform necessary accounting entries to complete claims processing.Exercise independent action and judgment in claims decisions.Communicate directly with policyholders, PR Representatives, Marketing Specialists, claimants, agents, and/or medical providers via telephone, e-mail, and written correspondence.Perform all duties with a high degree of accuracy.Other duties as required by the department.What You Can Bring:Bachelor's degree from a four-year college or university, or 1–2 years of related experience and/or training; or equivalent combination of education and experience.Six months' experience in a Claims Department Data Entry & Mail Distribution Representative position (LG4), or four years in a non-entry level position (LG4 or higher).Minimum typing requirement of 50 wpm.High School diploma or equivalent.Knowledge of medical coding and terminology; must score 98% or better on the Medical Terminology exam.Proficiency in Microsoft Office Suite (Outlook, Excel, Word) at an advanced level.Skilled in performing intermediate arithmetic calculations.Strong organizational skills and detail-oriented approach to work.Excellent written and verbal communication skills.Ability to thrive in a fast-paced environment while working independently and with limited supervision.Positive, team-oriented attitude with flexibility to adjust to changes as they arise.High technical aptitude with the ability to learn new systems quickly.Knowledge of the insurance industry and claims handling experience preferred.Promotion Opportunity: This position is eligible for the Claims Examiner II (LG8) position upon meeting the following criteria:One year of experience in the Claims Examiner position (LG7) and successful completion of ICA Medical Aspects of Claims and ICA Life and Health Insurance Law (or successor courses) — OR — five years of experience in the Claims Examiner position (LG7).Score 98% or better on the Medical Terminology exam.Demonstrate fully competent performance for two quarters preceding advancement in all functions performed in the Claims Examiner position (LG7).How American Income Life Will Support You:Looking to continue your career in an environment that values your contribution and invests in your growth? We've curated a benefits package that helps to ensure that you don’t just work, but thrive at American Income Life:Competitive compensation designed to reflect your expertise and contribution.Comprehensive health, dental, and vision insurance plans because your well-being is fundamental to your performance.Robust life insurance benefits and retirement plans, including a pension plan.Paid holidays and time off to support a healthy work-life balance.Parental leave to help our employees welcome their new additions.Subsidized all-in-one subscriptions to support your fitness, mindfulness, nutrition, and sleep goals.Company-paid counseling for assistance with mental health, stress management, and work-life balance.Continued education reimbursement eligibility and company-paid FLMI and ICA courses to grow your career.Discounted Texas Rangers tickets for a proud visit to Globe Life Field.Opportunity awaits! Invest in your professional legacy, realize your path, and see the direct impact you can make in a workplace that celebrates and harnesses your unique talents and perspectives to their fullest potential. At American Income Life, your voice matters.