Life Claims Specialist - Remote

Overview

The Claims Specialist I is responsible for analyzing and adjudicating claims for group Life and Accidental Death insurance plans in a timely and accurate manner and in strict accordance with defined carrier, state and federal requirements to ensure an excellent customer experience.

In Short

• Research submitted claims and records regarding eligibility and compliance with coverage provisions.
• Process Life and Accidental Death claims for timely and accurate responses.
• Generate correspondence to request required information from members and providers.
• Monitor and review pended claims for compliance.
• Support the Member Benefits Service Department with customer inquiries.
• Perform miscellaneous functions and special projects as assigned.

Requirements

• High school degree or equivalent.
• One year claims analysis and/or claims adjudication experience preferred.
• Knowledge of CPT codes, RVS codes, and ICD9/10 coding preferred.
• Basic proficiency in MS Office.
• Strong attention to detail and typing skills.
• Ability to work in a fast-paced environment.
• Excellent customer service and communication skills.
• Good deductive reasoning and problem-solving skills.

Benefits

• Health benefits including medical, dental, and vision.
• 401K with company match.
• Prefunded optional FSA.
• 100% covered Life Insurance.
• Short Term/Long Term Disability.
• $250 Wellness Benefit.
• 10 days of vacation your first year, increasing each year.
• 13 paid holidays each year.