Claims Examiner

Qualifications

• High School Diploma or equivalency required
• 2 or more years experience with claims and/or other related claims processes is required
• 1-2 years of customer service experience preferred
• Bilingual (Spanish/English) highly preferred

Requirements

• Exceptional customer service skills and stellar telephone etiquette with professional dictation and written communication skills
• Strong e-mail and internet skills
• Ability to analyze and resolve problems
• Ability to adapt to change
• MS Office Suite, including word, excel and access (typing min 50 wpm)
• Must be able to multi-task (computer, phone, and documents/reference manuals)

Skills

• Adjudicate, investigate and/or deny claims
• Enforce contractual requirements impartially and expeditiously
• Identify claims of a potentially fraudulent nature
• Process claims via phone and portal systems
• Handle customer service questions or transfer call to appropriate numbers
• Follow-up with Service Providers and Technicians for required claims information
• Handle ESC Resend Requests
• Participate in any projects, reports, documentation, tasks or objectives assigned

Pay

Details on pay are not specified in the job posting.

Schedule

Details on schedule are not specified in the job posting.

Benefits

Full benefit package including medical, dental, life, vision, company paid short/long term disability, 401(k), tuition assistance and more.