Associate - Insurance Claims

Responsibilities

Job Purpose

• Assist in the claim process by providing the following services: Communicate with Employers, Medical Facilities/Providers, Beneficiaries, and Claimants to gather more information/documents to provide a complete claim form before moving claim into IGO status.
  
  

• Analyze and process information received/not received to decide if claim moves to IGO or if claim follows our NIGO process where a determination is made on the claim. 25%
• Communicate, both written and verbally with claimants, employers, beneficiaries, and medical providers regarding claim status and to obtain/collect information to assist with the claim process. Fully document claim and maintain claim file for all communication. Maintain accurate monthly requirements/quality. 30%
• Initiate ways to improve the team and work efficiency. 10%
• Provide training/coaching and act as a resource for the NIGO/IGO team. 10%
• Organize, set priorities, and effectively manage caseload to ensure all requirements are met. May assist others in establishing their workload priorities. 25%
  
  

• High school diploma or GED required, or 1-2 years related work experience
• Ability to maintain a high degree of accuracy while being detail oriented required
• Must be able to work in a team environment
• Good analytical, organizational, problem solving and decision-making skills
• Ability to maintain confidentiality
• Strong verbal and written communication skills (must be able to communicate with individuals experiencing illnesses, financial losses, or deaths of loved ones as well as legal and/or medical professionals)
• Ability to maintain good public relations with customers (employers, employees, and beneficiaries