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Accident & Health Claim Examiner

Roles & Responsibilities

  • High School Diploma or equivalent
  • Ability to function independently within established guidelines
  • Excellent interpersonal, oral and written communication skills
  • Intermediate skill level in Microsoft Office programs

Requirements:

  • Review and analyze claims to ensure they are processed accurately and in accordance with policy provisions.
  • Handle moderate to complex claim issues, ensuring that all necessary documentation is obtained and claims are approved or denied based on established guidelines.
  • Release accurate benefit payments in accordance with CBP policy and other applicable TPAs or SLA agreements, and maintain proper documentation in the claim system.
  • Receive inbound calls within assigned queues and/or as overflow for the CSR team, and coordinate follow-ups for documentation.

Job description

We are looking for Claims Coordinator to join our team. In this role, you will be responsible for reviewing and analyzing claims to ensure they are processed accurately and in accordance with policy provisions. You will handle moderate to complex claim issues, ensuring that all necessary documentation is obtained, and claims are either approved or denied based on established guidelines.

Your Impact:

  • Analyze and research claim issues of moderate to complex difficulty.
  • Ability to comprehend complicated workflows, policy certificates and policy provisions.
  • Review and apply policy provisions in processing of claims received.
  • Request and obtain necessary documents for claim processing/consideration, including scheduling follow ups for documentation.
  • Release of accurate benefit payments in accordance with CBP policy, industry standard & other applicable TPA or SLA agreements.
  • Proper documentation of required information in claim system, including follow up information.
  • Receive inbound calls within assigned queues and/or as overflow for the CSR team

Successful Candidate Will Have:

  • High School Diploma or equivalent
  • Ability to function independently within established guidelines
  • Excellent interpersonal, oral and written communication skills
  • Intermediate skill level in Microsoft Office programs

About One80:

One80 Intermediaries is part of Arrowhead Intermediaries, a global insurance distribution platform that offers deep specialization, scale, and innovation across wholesale brokerage, program administration, and specialty insurance. With more than 7,000 professionals worldwide and a collective portfolio exceeding $18 billion in premium placed in 2024, our combined organization delivers a diverse trading platform for insurance carriers as well as expanded access and niche solutions for brokers and customers navigating complex and hard-to-place risks. The platform combines entrepreneurial culture with operational excellence to deliver tailored solutions and long-term value across the insurance ecosystem.

Pay Range:

$15.00 - $18.00 Hourly

The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for this role.

One80 Intermediaries is an equal opportunity workplace and is committed to ensuring equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, Veteran status, or other legally protected characteristics.

Learn more about working at One80 Intermediaries by visiting our careers page: www.one80.com/careers.

Personal information submitted by California applicants in response to a job posting is subject to One80's  California Job Applicant Privacy Notice .

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