Claims Specialist 1-Remote

Wellabe; Des Moines (IA); Hybrid; USD 42,000 - 56,000; Full time

Benefits offered by this job

Hybrid availability

401(k) match

Health insurance

Paid time off

Holidays

Volunteer time off

LSA

Paternity leave

Job summary

Wellabe is seeking a Claims Specialist 1 to process, review, and adjust routine life or health claims. This role requires accurate entry of codes and data, with complex claims escalated to senior staff.

You will respond to inquiries from agents, policyholders, and providers, and may cross-train on other products in health lines, including Medicare Supplement and hospital indemnity.

Qualifications

• General knowledge of claims processing policies and procedures.
• Strong verbal and written communication skills.
• Intermediate computer skills with MS Office suite.
• Ability to meet procedural, financial and quality metrics including compliance.

Responsibilities

• Review, analyze and process routine life or health claims, including data entry.
• Respond to inquiries from agents, policyholders and providers by phone, email, or letter.
• Coordinate with back-office teams and handle related duties; cross-train on other products.

Skills

Claims processing

HIPAA compliance

MS Office

Communication skills

Education

High school diploma or GED

Tools

MS Office (Excel, Word, PowerPoint)

Job description

Wellabe is looking for a Claims Specialist 1 to join our team. The Claims Specialist 1 is responsible for processing, reviewing, and adjusting routine life or health claims.

Be successful in this role

Someone in this role will:

• Review, analyze and process claims, adjustments, coordination of benefits and refunds on routine life or health claims including accurate entry of codes and data to applicable system. Work may be reviewed for accuracy and more complex claims referred to a more experienced specialist.
  • Life - responsible for final expense or preneed products.
  • Health - responsible for Medicare Supplement, Dental or Hospital Indemnity or other related products.
• Respond to general inquiries by agents, policyholders, and providers concerning policy coverage and other related information by phone, email, letter or other communication channels.
• Health - Cross train on one or more other products and/or back up medical records, transmittal, provider files or other related duties.

Qualifications

• General knowledge of the principles, processes, and practices related to claims processing including local, state, and government insurance-related policies.
• Strong verbal and written communication skills.
• Intermediate computer skills with basic knowledge of MS Office Suite (Excel, Word, and PowerPoint).
• Ability to meet or exceed all procedural, financial and quality metrics including production standards, adjudications, quality, state and federal compliance regulations, etc.
• Acts in accordance with all HIPAA Privacy and Security guidelines to ensure confidential handling of protected health information.
• High school diploma or GED equivalent.
• Previous related experience, a plus.

Benefits

• Hybrid availability
• 401(k) with company match
• Health insurance
• Paid time off, holidays
• Volunteer time off
• Lifestyle Spending Account (LSA)
• Paternity leave

Growth opportunities

We believe each of us has potential to grow and adapt with our business. We take your career as seriously as you do. Helping you develop your skills and talents leads to opportunities - not only for you, but also for our company. That's why we provide:

• LinkedIn Learning Premium access
• CliftonStrengths assessment and coaching
• On-site and virtual workshops and cohorts featuring world-class content from FranklinCovey, Crucial Learning, Gallup, and more
• Free world-class insurance acumen courses through AHIP and LOMA
• Reimbursement and bonus opportunities for professional designations and certifications, including a tuition reimbursement program
• Opportunities to take part in Wellabe's mentorship programs

About Wellabe

Since 1929, Wellabe has been finding solutions to help our customers protect their health and financial well-being. And we're committed to fostering an internal culture of inclusivity, well-being, and development so each of our team members can succeed. Learn more about Wellabe's culture of betterment by visiting wellabe.com/culture.

Wellabe is full of smart, caring, hard-working people with a broad range of talents who understand collaboration is key. We bring our best selves every day, to connect with others to solve problems, spark innovation, and bring ideas to life. Meet the team and learn what makes Wellabe a great place to work by visiting wellabe.com/news/employee-spotlights.

Our core values:

• Be dedicated:Show unwavering commitment by proactively taking initiative, setting clear goals, and managing time effectively.
• Be trustworthy:Take accountability for actions, navigate difficult conversations with integrity, and build strong relationships through consistent, honest behavior.
• Be determined:Demonstrate enthusiasm and a relentless drive to overcome obstacles and achieve goals.
• Be collaborative:Foster teamwork by being self-aware, actively listening, and effectively communicating across all levels.
• Be open:Embrace diversity and new ideas to create an inclusive environment.
• Be generous:Embody generosity and compassion by serving a greater purpose and helping others.
• Be better:Commit to continuous improvement and adapt effectively to change.
• Be well:Prioritize physical and mental health, manage stress, and demonstrate emotional intelligence.