Associate - Accidental Claims Analyst

Responsibilities

As an Accident Claims Analyst In this fast-paced environment, every single day offers new challenges and the ability to use excellent analytical, multitasking, prioritization, and interpersonal skills to assist with clients’ short-term disability claims – all during a time in which they may be facing major changes in life.

• Acquire, analyze, and investigate medical, financial and contractual information to make effective and timely claim decisions.
• Connect with employers, employees and medical providers via phone, email, text, and letters.
• Provide customers with updates regarding medical conditions, restrictions & limitations, job duties, group short term disability policy provisions, claim decisions, status, and all other aspects of the claim process to ensure they fully understand the companys position.Supervise and follow up on outstanding items to ensure compliance with regulations, service timing, and quality guidelines.
  
  

• PHRN with Claims Experience
• Non-PHRN: 1 year Contact Center/ Claims Processing Background
• Claim Processing Experience – reviewing and gathering information, making phone calls, and making the actual claim decision.
• Legal and policy experience - being able to read, interpret policies, policy provisions and industry regulations to accurately interrupt and apply them to claims situations is preferred.
• Basic math skills.
• Ability to actively listen while you collect information on the telephone and provide strong customer service, providing empathy to the customers going through tough situations.
• Ability to accept & apply feedback.
• Ability to maintain a high degree of accuracy, pay strict attention to detail, maintain confidentiality, and work within the grey.
• Excellent analytical, interpersonal, problem solving, decision-making, and multi-tasking skills.
• Computer skills and typing proficiency – Microsoft Outlook, Word, Excel experience is preferred.
• Work independently as well as in a team environment.