Claim Manager Assistant I

This is a fully remote position, open to applicants in Alabama.

📋 Description

• Deliver outstanding internal and external Customer Support in a phone-based role.

• Assist insured individuals, their representatives, and healthcare providers by facilitating the handling of highly personalized claim inquiries.

• Respond to inquiries in a professional manner or direct them appropriately by adhering to established standards and guidelines.

• Ensure a seamless transition of claims while monitoring the aging of assigned tasks to meet turnaround time objectives.

• Utilize active listening skills to identify and address the needs of inbound and outbound callers, responding in a professional and suitable manner.

• Prepare claims for review and adjudication by the Claim Manager.

• Process and document daily administrative tasks related to claim notifications, including pending, open, and closed claims, while managing multiple tabs/screens within a centralized work queue.

• Ensure accurate and detailed data input and note-taking consistently in line with established standards.

• May undertake additional responsibilities and/or assist with special projects as necessary.

• Manage and organize files effectively.

• Maintain electronic file management and organization of incoming and outgoing mail, which includes imaging, indexing, and classification of documents.

• Thoroughly review all documentation for completeness, credibility, consistency, and order.

• Identify potential process inefficiencies and propose feasible solutions.

• Consistently meet or exceed all established minimum expectations/metrics and goals for the position.

• Meet or surpass productivity and quality standards as defined for the role.

• Handle all confidential information in compliance with HIPAA privacy regulations.

• Ensure a smooth transition of inquiries to the appropriate department when necessary.

⛳️ Requirements

• High school diploma or equivalent experience is required; business experience is preferred.

• Previous customer service experience is essential; experience in insurance or the medical field is preferred.

• Exceptional organizational abilities with a keen attention to detail.

• Familiarity with medical terminology is an advantage.

• Demonstrated interpersonal, verbal, telephonic, and written communication skills.

• Must exhibit a high level of tact, diplomacy, and professionalism when interacting with diverse customers.

• Ability to prioritize tasks using strong organizational and decision-making skills.

• Detail-oriented with the capacity to work independently and collaboratively within a team.

• Proficient in Microsoft Office products and other business-related software.

• Quick learner of new system applications.

• Ability to effectively apply learned principles to specific and unique situations.

🏝️ Benefits

• Medical, dental, and vision insurance plans to support your health and that of your family.

• A 401(k) plan with employer matching contributions.

• Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees.

• Paid holidays.

• Life insurance along with short-term and long-term disability coverage.

• Paid sick leave, paid family and parental leave, and other mandated benefits.