Established Senior Claims Examiner
Are you looking for a company that provides great work life balance and benefits? This is an opportunity to join a reputable financial services Market Leader who is currently seeking an established Sr. Claims Examiner.
- Audit and process large reinsurance Stop Loss claims submitted by Third Party and/or Self-Funded Claims Administrator in accordance with the Summary Plan Document and
- Stop Loss Policy provisions; claims using automated claims system.
- Handle complex telephone and written inquiries from policyholders, claimants, claims administrators and other internal and external customers.
- Bring claims to satisfactory conclusion to include verifying eligibility using various source documents, initiating written and/or telephone inquiries to clients, and to the final stage of releasing claims' benefit payments.
- Research and communicate information relative to claims eligibility, appeals and denials.
- Maintain good relationships with clients.
- Assist other staff members in processing of claims as needed.
- Perform other job related duties as may occasionally be assigned.
- Two years of administrative experience, preferably in an insurance environment.
- Working knowledge of insurance terminology, medical terminology, ICD-9, CPT-4 and HCSPC coding
- Must successfully demonstrate ability to meet or exceed productivity and error ratio standards.
- Demonstrated oral and written communication skills
Qualified candidates should send their resume OR call Sparks Group for additional details. Please note resume must include a valid email address in order to be considered.
We look forward to discussing your background, your current job search, and your potential career path with Sparks Group!
Apply for Established Senior Claims Examiner
Already uploaded your resume? Sign in to apply instantly