Claims Intake

About the role

We are a leading provider of business process outsourcing for the insurance industry, managing policies for the nation's largest insurers. We also provide clients with unique risk management insight built upon our proprietary databases. This position is responsible for reviewing and determining all claim requirements needed for initial and continuation claims. You will assist Care Managers and Care Coordinators while providing quality customer service to our policyholders, their representatives, and providers.

Responsibilities

• Reviews internal databases, client guidelines, and policy contract language to determine all claim requirements needed for initial and continuation claims.
• Reviews documented claim forms and contacts the insured, insured's representative, or provider to request information needed to process the benefit inquiry.
• Keeps clear and concise documentation of all claim intake activity within the required databases.
• Meets quality and production metrics as established and communicated by the department.
• Processes requests from the client or from other departmental areas within illumifin.
• Other duties as assigned.