Remote Claims Coordinator (12-Month Contract)

Manion Wilkins & Associates Ltd.; United States; Remote; USD 45,000 - 55,000; Full time

Job summary

Disability Management Institute (DMI) is seeking a Claims Coordinator for a 12-Month Contract who serves as the first point of contact for employees with Disability, Life and Living coverage. You will explain claims processes and review all claims-related paperwork to ensure accuracy.

This remote role supports our national operations, requires working within core business hours, and emphasizes thorough documentation, timely responses, and collaboration with carriers, HR, and claims teams to

Qualifications

• 2 years of administrative and/or customer service experience.
• Benefits experience is an asset.
• Proficient in Microsoft Excel, Outlook, and Word.

Responsibilities

• Review referrals from employers with disability coverage.
• Set up pre-claim files and refer to EIP team for facilitation, RTW planning, and app submission to carrier.
• Forward completed claims to Intake Coordinator for claim set-up and assignment to a Case Manager.
• Set up internally adjudicated Life and Living claims and facilitate the claim through to assignment to a Case Manager.
• Receive and review all new claim documents and referrals for Disability and Life & Living applications for various insurance carriers in accordance with their defined processes.
• Set up new files, verifying all administrative details required when submitting a claim for benefits, including absence dates and personal contact information.
• Assemble and submit claims to external carriers following standard procedures, maintaining claim records and communicating updates to relevant stakeholders until closure.
• Discuss the application process with employees and employers and ensure all correct paperwork is in order.
• Verify all administrative details required when submitting a claim for benefits, including absence dates, personal contact information, enrollment cards, and contracts.
• Review all application paperwork received to ensure it is complete and accurate; follow up with the relevant party to resolve any errors or omissions.
• Follow up on outstanding paperwork and ensure all stakeholders are kept updated.
• Review policy information to confirm insurance coverage for clients; elevate questions to the appropriate party where identified.
• Identify cases where return to work may be feasible prior to claim submission and propose and monitor plans.
• Notify the GS and GH billing administration team to apply applicable updates to WEBS.
• Respond to all inquiries, emails, and voicemails within 1 business day of receipt.
• Ensure all relevant file information is completely and accurately entered into the appropriate fields in the proprietary database management system.
• Manage incoming and outgoing phone calls in alignment with role responsibilities.
• Submit IT tickets for enhancements and support in conjunction with leadership sign-off.
• Provide input where inefficiencies are identified to improve outcomes and increase efficiency.
• Perform all other duties as required.

Skills

Admin experience

Customer service

Tools

Microsoft Excel

Outlook

Word

Job description

Disability Management Institute (DMI) is seeking a Claims Coordinator for a 12-Month Contract who serves as the first point of contact for employees with Disability, Life and Living coverage. You will explain claims processes and review all claims-related paperwork to ensure accuracy.

This remote role supports our national operations, requires working within core business hours, and emphasizes thorough documentation, timely responses, and collaboration with carriers, HR, and claims teams to