Job Description:
• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
• Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
• Ability to review, understand and interpret contracts.
Requirements:
• 4+ years of claims management experience or equivalent combination of education and experience required.
• High School Diploma or GED required.
• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Home State License and ability to obtain New York licensing is a requirement for this role
Benefits:
• medical
• dental
• vision
• 401k and matching
• PTO
• disability and life insurance
• employee assistance
• flexible spending or health savings account
• other additional voluntary benefits
• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment.