Remote Absence & Claims Management Expert

Matrix Absence Management, Inc.; United States; Hybrid; USD 43,000 - 53,000; Full time

Benefits offered by this job

Annual performance bonus

401(k) company match

Medical plans

Health Savings Account

Dental and vision

Life & Disability Insurance

Parental Leave & Adoption Assistance

Hybrid work arrangements

Tuition Reimbursement

Paid Time Off

Volunteer days

Employee Resource Group

Job summary

Reliance Matrix is seeking a Claims Examiner in the United States to serve as a liaison among clients, claimants, and healthcare providers. You will apply claims management, interpret contract provisions, and ensure accurate coding and timely claim transitions.

The role emphasizes compliance, confidentiality, and delivering reliable service while meeting performance targets. Responsibilities include investigation of issues, collaboration with departments, and ongoing training to stay current

Qualifications

• High School Diploma or GED (Bachelor’s preferred).
• Ability to develop proficiency regarding required RSL products, systems and processes related to the effective delivery of new business proposals.
• Attention to detail, analytical skills, and the ability to collaborate with others and work independently.
• Strong organizational skills, including the ability to prioritize work and multi-task.
• Customer service experience and orientation.
• Written and verbal communication skills.

Responsibilities

• Acts as a liaison between client, employee and healthcare provider.
• Applies appropriate claims management by providing reliable and responsive service to claimants and clients.
• Investigates claim issues providing resolution within guidelines.
• Interprets and administers contract provisions: eligibility and duration.
• Codes all system fields with correct financial, diagnosis and duration information.
• Coordinates with other departments to ensure claims transition or timely return to work.
• Maintains compliance with procedures and Unfair Claims Practice regulations.
• Manages Performance Guarantee clients and meets metrics.
• Maintains confidentiality and HIPAA compliance.

Skills

Attention to detail

Analytical skills

Customer service

Written communication

Verbal communication

Education

High School Diploma

Bachelor's degree preferred

Tools

Microsoft Office

Job description

Reliance Matrix is seeking a Claims Examiner in the United States to serve as a liaison among clients, claimants, and healthcare providers. You will apply claims management, interpret contract provisions, and ensure accurate coding and timely claim transitions.

The role emphasizes compliance, confidentiality, and delivering reliable service while meeting performance targets. Responsibilities include investigation of issues, collaboration with departments, and ongoing training to stay current