Absence Management Specialist

Job Responsibilities

The Claims Examiner will act as a liaison between client, employee and healthcare provider. In this position, you are responsible for applying appropriate claims management by providing reliable and responsive service to claimants and clients.

• Investigates claim issues providing resolution within departmental and regulatory guidelines.
• Interprets and administers contract provisions: eligibility and duration.
• Accurately codes all system fields with correct financial, diagnosis and duration information.
• Collaborates with other departments to ensure appropriate claims transition or facilitate timely return to work.
• Adheres to compliance, departmental procedures, and Unfair Claims Practice regulations.
• Actively contributes to customer service, quality and performance objectives.
• Proactively engages in departmental training to remain current with all claim management practices.
• Manages Performance Guarantee clients and meet targeted metrics.
• Maintains and protects personal health information.
• Maintains a high level of confidentiality and abides by HIPPA rules and regulations.

Qualifications

• High School Diploma or GED (Bachelor’s preferred).
• Ability to develop proficiency regarding required RSL products, systems and processes related to the effective delivery of new business proposals.
• Microsoft Office experience.
• Attention to detail, analytical skills, and the ability to collaborate with others and work independently.
• Strong organizational skills, including the ability to prioritize work and multi-task.
• Customer service experience and orientation.
• Written and verbal communication skills.

Pay and Benefits

The expected hiring range for this position is $24.00 hourly. This expected hiring range covers only base pay and excludes any other compensation components such as commissions or incentive awards. The successful candidate’s starting base pay will be based on several factors including work location, job-related skills, experience, qualifications, and market conditions. These ranges may be modified in the future.

Work location may be flexible if approved by the Company.

What We Offer

• An annual performance bonus for all team members.
• A generous 401(k) company match that is immediately vested.
• A choice of three medical plans (that include prescription drug coverage) to suit your unique needs.
• For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account.
• Multiple options for dental and vision coverage.
• Company provided Life & Disability Insurance to ensure financial protection when you need it most.
• Family friendly benefits including Paid Parental Leave & Adoption Assistance.
• Hybrid work arrangements for eligible roles.
• Tuition Reimbursement and Continuing Professional Education.
• Paid Time Off – new hires start with at least 20 days of PTO per year in addition to nine company paid holidays.
• Vacation days, community partnerships, and Employee Assistance Program.
• To connect with colleagues around the country, we offer an Employee Resource Group program.

Our Values

• Integrity.
• Empowerment.
• Compassion.
• Collaboration.
• Fun.

EEO Statement

Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications.