Senior Assistant Claims Examiner

Senior Assistant Claims Examiner

DXC | victoria, VIC, AU

Posted 3 days ago

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Description

Job Description:
Essential Job Functions
Enters insurance claims received electronically or in written form.Answers incoming customer calls regarding claim processing. Documents claim and associated history.Evaluates available information to validate claims. Verifies policyholder information, policy effective dates, premium status and verification of claim eligibility.Sends claim form to claimant for updating, correction or completion.Investigates simple to moderately complex claims and determines level or resolution if appropriate; advises claimant of status; assists in negotiating settlement and resolution of claim.Identifies need for additional information; contacts appropriate source to obtain needed information. Verifies beneficiary or claimant information if claim is warranted. Identifies payment amount and obtains required management approvals for payment. Processes payment.Basic Qualifications
High school diploma or G.E.D.Fellowship of Life Health Claims (FLHC) Certification preferredTwo or more years of auditing, accounting, contracts or information technology experienceExperience working with insurance and/or medical terminologyExperience working with appropriate claims processing procedures and documentationOther Qualifications
Good analytical and problem solving skillsGood interpersonal skills to interact with team membersGood communication skills to communicate with clientsGood data entry skillsNegotiation skills to interact with claimantAbility to keep sensitive and confidential material privateAbility to work in a team environmentWork Environment
Office environment