Claims Processing Associate

Amwins; United States; Hybrid; USD 42,000 - 65,000; Full time

Benefits offered by this job

PTO

Paid holidays

Annual bonus program

Learning & development

Job summary

Amwins Self-Funded, LLC is seeking a Claims Processing Associate for a primarily in-office role with the flexibility to work from home up to 2 days a week after training. You will learn the Amwins business model, communicate with carriers and clients, and manage monthly claim reporting and reimbursements.

The role emphasizes accuracy, confidentiality, and teamwork, with a benefits package including PTO, holidays, and a performance-based annual bonus.

Qualifications

• Diploma or equivalent work experience preferred.
• Proficiency with Microsoft Office Suite (Word, Excel, Outlook, Teams).
• Strong critical thinking and problem-solving abilities.
• Ability to maintain confidentiality.
• Excellent organizational and time-management skills.
• Strong written and verbal communication abilities.
• Attention to detail and sense of urgency.
• Eagerness to learn Stealth’s business model.

Responsibilities

• Learn Amwins Business Model: Understand Amwins business model and the products we support under the guidance of the Claims Manager and Lead Claims Auditor.
• Effective Correspondence: Correspond accurately and timely with carriers, administrators, clients, and brokers using approved form letters and emails, with all correspondence copied to the Claims Lead.
• Claim Reports Management: Manage monthly claim reports for the administration of the assigned book of business, ensuring forwarding to the appropriate carrier and following up on missing reports.
• Reimbursement Request Review: Review submitted reimbursement requests for completeness and request any missing information.
• Eligibility Documentation Approval: Obtain approval from the Claims Lead on eligibility documentation noting time-off exceeding twelve (12) weeks before submitting a claim reimbursement request.
• Claim Submission and Tracking: Record and submit reimbursement requests to the appropriate carrier within authorized dollar authority, tracking and following up on outstanding payments.
• Reimbursement Issuance: Review and issue reimbursements, notifying designated contacts accurately and in a timely manner.
• Claim Tracking Logs: Maintain internal claim tracking logs to ensure accurate records.
• Year-End Account Closure: Manage the settlement of all reimbursement requests at the end of the plan year to properly close the client’s account.
• Adaptability and Team Collaboration: Handle other duties and projects as assigned, showcasing adaptability and strong collaboration skills.

Skills

Critical Thinking

Confidentiality

Organizational Skills

Communication Skills

Attention to Detail

Eagerness to Learn

Multitasking

Education

Diploma or equivalent work experience

Tools

Microsoft Office

Word

Excel

Outlook

Teams

Job description

Remote

Join Our Team as a Claims Processing Associate at Amwins Self-Funded, LLC!

Are you ready to make a meaningful impact in the dynamic world of insurance? Join Amwins Self-Funded, LLC., as a Claims Processing Associate.This is an in-office position, that offers the flexibility to work from home up to 2 days a week after completing training.

Why Choose Amwins?

• Flexibility: Enjoy a hybrid work environment with flexible scheduling options.
• Comprehensive Benefits: Access a competitive benefits package from day one, including generous Paid Time Off (PTO) and paid holidays.
• Continual Learning: Thrive in a collaborative, education-focused work environment.
• Annual Bonus Program: Earn incentives through our performance-based bonus program, designed to reward you for achieving key goals and contributing to the company's success.

Learn more about us at amwins.com/benefits.

Responsibilities

• Learn Amwins Business Model: Understand Amwins business model and the products we support under the guidance of the Claims Manager and Lead Claims Auditor.
• Effective Correspondence: Correspond accurately and timely with carriers, administrators, clients, and brokers using approved form letters and emails, with all correspondence copied to the Claims Lead.
• Claim Reports Management: Manage monthly claim reports for the administration of the assigned book of business, ensuring forwarding to the appropriate carrier and following up on missing reports.
• Reimbursement Request Review: Review submitted reimbursement requests for completeness and request any missing information.
• Eligibility Documentation Approval: Obtain approval from the Claims Lead on eligibility documentation noting time-off exceeding twelve (12) weeks before submitting a claim reimbursement request.
• Claim Submission and Tracking: Record and submit reimbursement requests to the appropriate carrier within authorized dollar authority, tracking and following up on outstanding payments.
• Reimbursement Issuance: Review and issue reimbursements, notifying designated contacts accurately and in a timely manner.
• Claim Tracking Logs: Maintain internal claim tracking logs to ensure accurate records.
• Year-End Account Closure: Manage the settlement of all reimbursement requests at the end of the plan year to properly close the client’s account.
• Adaptability and Team Collaboration: Handle other duties and projects as assigned, showcasing adaptability and strong collaboration skills.

Qualifications

• Education and Experience: A diploma or equivalent work experience is strongly preferred.
• Tech Proficiency: Proficiency with Microsoft Office products (Word, Excel, Outlook, and Teams) is preferred.
• Critical Thinking: The ability to critically think and problem-solve.
• Confidentiality: Ability to maintain strict confidentiality.
• Organizational Skills: Ability to multitask, adjust to changing priorities, and effectively manage time to meet deadlines.
• Communication Skills: Effective written and verbal communication skills with both internal and external parties.
• Attention to Detail and Urgency: A sense of urgency and attention to detail are necessities.
• Eager to Learn: Eagerness to learn Stealth’s business model is a necessity.