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Claims Examiner

Our client is looking for a Claims Examiner to join their team for a 6+ month contract.
*100% REMOTE*



Job Requirements:

Ideal Candidate / Must Haves:

  • Proficient with Microsoft Office, ICAS & AWD
  • Demonstrates ability to work in a fast-paced environment.
  • Demonstrates strong interpersonal skills with a collaborative style.
  • Demonstrates strong organizational skills with the ability to prioritize workload and multi-task while maintaining strict attention to detail.

Additional Skills:

  • Ability to perform under stress in cases of emergency, critical or hazardous situations.
  • Ability to work with others in a team environment.
  • Demonstrates the ability to use sound judgment and discretion regarding confidential information.
  • Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).

Responsibilities:

  • Successfully completes regulatory and job training requirements.
  • Demonstrates solid relationship management skills with internal and/or clients (e.g. management, peers, colleagues, customers, etc.).
  • Supports and promotes change management and/or departmental/enterprise initiatives within assigned area(s) of responsibility.
  • Meets or exceeds departmental quality and service standards.
  • Works overtime as needed.
  • Delivers routine work independently, in accordance with established procedures and guidelines, in a timely manner and meets deadlines appropriately.
  • Makes routine & non-routine decisions under close supervision, applying limited discretion within role except for matters of significance which affect the business as a whole or a significant part of it, in accordance with established procedures/guidelines
  • Performs task by applying core knowledge obtained from the role and acquires increasingly more knowledge to apply in the role.
  • Processes assigned claims for payment or denial in accordance with established procedures and guidelines, in a timely manner and meeting departmental quality/production standards.
  • Reviews and provides specific information to questions/concerns from internal/external stakeholders (e.g. internal partners, policyholders, brokers, etc.) by applying core knowledge obtained for the role.
  • Applies core knowledge obtained for the role to effectively communicates verbally and in written form with internal/external stakeholders to obtain needed information while maintaining a professional demeanor in all interactions.
  • Reviews submitted claim information for payment.
  • Ensures the accuracy and completeness of submitted claims.
  • Escalates claims issues or concerns to senior team members and/or management.
  • Provides superior customer service to internal and/or external stakeholders, recognizes what needs to be done to meet customer needs and demonstrates flexibility and responsiveness to meet customer needs.
  • Recognizes general issues/concerns for assigned area(s), explains effect on the customer's service experience, and suggests process improvements.

Additional Job Requirements:

  • Carries out duties in compliance with all state and federal regulations and guidelines. Complies with all company and site policies and procedures.
  • Remains current in profession and industry trends.
  • Makes a positive contribution as demonstrated by:
    • Making suggestions for improvement
    • Learning new skills, procedures and processes
Posted
11/20/2021
Salary Range
$30,000.00 - 49,000.00
per Year
Salary range estimated by
Location
Atlanta, GA 30301, US