Offer summary

Qualifications:

High school diploma or equivalent is required., Basic business and computer skills are essential., Ability to work independently and research medical details., Willingness to learn, adapt, and follow instructions..

Key responsibilities:

Review applications and medical documentation to determine insurance approval.

Process and evaluate Statement of Health applications accurately.

Maintain customer focus to strengthen client relationships.

Work in a team environment adhering to quality and attendance standards.

Job description

Job Description: Claims Reviewer

Pay Rate: 27.50/hr
Standard Assignment Window: September to February with possible extension
Fully Remote

Training:
o Training is fully virtual with cameras expected to be on. Start time is 8 AM Eastern Time. Training period consists of 3 weeks in virtual classroom and at least 3 additional weeks of training audits with reduced scheduling. The duration of this training audit period is contingent upon meeting quality standards.
o Once training is fully completed, some flexibility exists but standard business hours (8AM Eastern start time) is expected.
o Role is fully virtual; this requires access to high-speed Wi-Fi/cable/DSL internet (must be private/secured connection), a dedicated area to work with minimal interruption, and a smart phone.
o Expected to be on camera for training and team meetings.

Description
Review applications and medical documentation received from applicants/medical facilities to determine if Group Life or Disability insurance should be approved.

Responsibilities include:
• Examines and processes Statement of Health Applications; determines whether to return, put on pending, deny, approve or request additional medical information.
• Perform tasks in a customer focused manner to enhance and strengthen the relationship between the customer and ***.
• Processing customer applications in a concise, efficient and accurate manner with attention to detail.

Skills required include:
• Basic business acumen expected (i.e., written and verbal skills)
• Computer skills; proficient in use of multiple systems and technology resources.
• Able to maintain consistency of quality standards by utilizing job aids, work instructions and verbal direction.
• Ability to work independently to investigate medical details (i.e., research medical conditions and medications).
• Able to take feedback, shows a willingness to learn and adapt.

Required:
Requires a high school diploma or equivalent.
Relies on instructions and pre-established guidelines to perform the functions of the job.
Requires working in a large team environment with direction from various supervisory roles.
Expected to maintain a set level of quality, production and attendance standards, as well as maintain communication with team leads.

Required profile