Claim Specialist III (Remote)
This Claims role is responsible for the investigation, communication and settlement of claims.
Specialist – Possesses detailed knowledge and/or skill on a particular subject or activity. Their talents are devoted to a particular business focus and they provide guidance, technical leadership, and training to less experienced staff. Develops and implements solutions that align with key business strategies and initiatives.
- Investigate claim files to determine steps needed to complete the settlement of claims.
- Communicate directly with third parties and customers to request medical, employment or other information needed to make a claim decision.
- Analyze information received in order to make an independent claim decision.
- Provide a proactive customer service experience characterized by keeping all parties informed of the claim status, next steps and claim decision.
- Manage pending caseload focused on disability management and duration control while managing individual productivity and service levels.
- Actively engage in an inclusive team environment by participating in team meetings and team projects.
The above statement of duties is not intended to be all inclusive and other duties will be assigned from time to time.
- Associate degree or equivalent work experience
- Strong analytical, critical thinking, problem solving and independent decision making skills
- Demonstrated interpersonal and customer service skills
- Excellent communication skills
- Intellectual curiosity and the desire to learn
- Experience in medical or health insurance fields or disability experience is preferred
- Ability to successfully pass required exams or coursework
**Position is open to remote employment throughout the US.