[Hiring] Claims Examiner @reputed company

Role reputed company This position is responsible for examining routine and non-routine claims for one or more products and multiple series of reputed company by evaluating the extent of liability reputed company established guidelines. This position is accountable for analyzing claims to determine benefit/contract eligibility and processing claim transactions reputed company specified dollar limits in compliance with state and federal regulatory standards, and NAIC (National Association of Insurance Commissioners) guidelines. Additionally, this position is a member of reputed company, reputed company partners with peers on meeting established service and reputed company standards, provides coaching and training to other Examiners and identifies opportunities for process improvements. • Determine extent of liability on routine and non-routine claims and reputed company final claim reputed company reputed company specified dollar limits. • Contribute to accurate fraud detection and reporting by referring suspected fraud to appropriate staff for review according to established procedures. • Analyze claim transactions and process payments utilizing various work reputed company, administrative, and reputed company (Line of Business) systems, accurately and cost effectively according to contract provisions and in compliance with internal service and state and federal regulatory standards. • Ensure high level of customer satisfaction by partnering with members, financial associates, doctors, providers, attorneys, police, vendors and other reputed company customers regarding claims, settlements and interpretation of policy provisions. • Handle sensitive written and verbal communications. • reputed company participate in the development and implementation of business processes, reputed company operating procedures, documentation and other support materials required for unit operation. • reputed company consultation to Associate Claims Examiners in helping to answer questions and reputed company reputed company on claims with a moderate level of complexity. Qualifications • High school required. College degree preferred. • Minimum of 2 years relevant experience. • reputed company credentials preferred (e.g. LOMA, ICA). • Intermediate knowledge of claim administration and operations as reputed company as pertinent laws and regulations. • Must possess strong interpersonal skills, as reputed company as excellent verbal and written communication skills. Requirements • As part of reputed company Financial's hiring process, a verification of a candidate's background will be made to complete the hiring process. • May represent reputed company at depositions and court appearances. Benefits • Various bonuses (including, for example, annual or long-term incentives). • Medical, dental, and reputed company insurance. • Health savings account. • Flexible spending account. • 401k. • Pension. • Life and accidental death and dismemberment insurance. • Disability insurance. • Supplemental protection insurance. • 20 days of reputed company Time Off reputed company year. • reputed company and reputed company Time. • 10 reputed company company holidays. • Volunteer Time Off. • reputed company parental leave. • EAP. • reputed company-being benefits, and other employee benefits. Apply tot his job Apply To this Job