Health & Accident Claims Examiner - Solve Complex Claims

Brown & Brown Insurance; United States; Remote; USD 25,000 - 26,000; Full time

Benefits offered by this job

Health Benefits

401k

Student Loan Assistance

Tuition Reimbursement

Job summary

One80 Intermediaries is seeking an Accident and Health Claims Examiner to join our growing team. You will review and analyze claims to ensure accurate processing in accordance with policy provisions and guidelines.

This role handles moderate to complex claim issues, requests necessary documents, applies policy provisions, and ensures accurate benefit payments. Strong communication and Microsoft Office skills are required for success.

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

Oral communication

Written communication

Independent work

Microsoft Office

Education

High School Diploma

Job description

One80 Intermediaries is seeking an Accident and Health Claims Examiner to join our growing team. You will review and analyze claims to ensure accurate processing in accordance with policy provisions and guidelines.

This role handles moderate to complex claim issues, requests necessary documents, applies policy provisions, and ensures accurate benefit payments. Strong communication and Microsoft Office skills are required for success.