[Remote] Claims Examiner (Annuity)
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company that focuses on providing financial services, and they are seeking a Claims Examiner to evaluate and analyze documentation for claim payments or denials. The role involves reviewing claims, documenting communications, and collaborating with various departments to ensure compliance with regulations.
Responsibilities
- Under direct supervision, analyze information/documentation received to determine how to proceed with a review of a claim and determine methods of obtaining additional information from alternative sources
- Review claims and reputed company sources used in the review
- Document correspondence and conversations
- Correspond verbally and in writing with claimants, medical providers, medical examiners, and law enforcement
- Work closely with department manager, legal counsel, medical director, claims assistants, and other departments to gather information for contested claims
- Monitor claims for fraud and proceed according to each situation, such as engaging the Fraud team or additional research
- Maintain compliance with regulations
Skills
- Associate's degree in a business field or equivalent experience
- Excellent communication and customer service skills
- Organizational, problem-solving and analytical skills
- Ability to cross train and learn other products
- Ability to multi-task and adapt to change
- Claims experience
Benefits
- Annual Bonus of 6% based on the Company Bonus Plan/Individual Performance
Company Overview