Benefit Adjuster III - Leave Services
Evaluations and Processing
Evaluates, processes, manages and/or audits claims that require complex judgement and investigation such as Cancer claims, Leave Absence Management Claims, Short Term Disability claims, Permanent and Total Disability claims, Life claims, claims requiring Pre-Existing investigation, or claims related to Stop Loss.
Customer Interaction
Provides appropriate verbal and/or written communication to internal and external Customers in a positive and knowledgeable manner to ensure a high standard of Customer service. Acts as a direct contact and communicates with internal and external Customers and medical providers in a positive, knowledgeable and professional manner, providing them with direction and assistance in all facets of insurance coverage and needs.
Requirements
- Minimum 3 years claims processing experience
- FMLA/PFML experience required
- Prompt and reliable
- Advanced knowledge of medical terminology
- Proficient with PC Windows-based software, including Microsoft Office
- Easily adapts to new software/technology applications and is able to excel in a paperless environment
- Advanced contract knowledge
- Advanced familiarity with CPT and ICD-10 coding
- Possesses a high degree of decision-making ability
- Strong research and analytical skills
- Flexible work schedule, including willingness to work overtime as needed
- Strong communication skills, both verbal and written
- Ability to handle fast-paced environment
- Professional attitude
- Dedicated to providing world-class customer service
- Ability to work in a team environment
Compensation
Compensation range: $24.17/hour to $35.87/hour, plus may be eligible for an annual discretionary company bonus. Actual compensation within that range will be dependent upon the individual's skills, experience/qualifications and geographic zone.
For more information on our organization and company benefits please visit our career site at http://americanfidelity.com/careers/.