Claims Processor III

This is a fully remote position, open to applicants in Alaska, +26 more states.

📋 Description

• Assess, investigate, and resolve moderate to complex claims in accordance with established contracts and policies.

• Identify, examine, and address coordination of benefits, subrogation, and general inquiry matters.

• Communicate findings of claim resolutions through both written and verbal means, including inbound and outbound calls.

• Execute claim adjustments, reversals, and/or refunds as necessary.

• Serve as the team's technical subject matter expert.

• Provide training and auditing for trainee claims, offering feedback and technical assistance.

• Ensure reference materials are kept current.

• Compile formal history reviews.

• Achieve cycle time and productivity targets that align with corporate goals.

• Safeguard the confidentiality of documents and files.

• Convert data into formats acceptable to the claims processing system and follow up on pending claims.

• Implement quality practices to minimize defects and internal rework.

• Undertake additional duties and special projects as assigned.

⛳️ Requirements

• High School diploma or GED (Required).

• A minimum of one (1) year of experience in claims processing or customer service (Required).

• Familiarity with Out-of-area programs.

• Experience with team-focused audits.

• Capability to exert up to 10 lbs. of force occasionally and/or a negligible amount of force frequently or continuously.

• Proficiency in keyboarding and the ability to communicate clearly and effectively both in person and over the phone.

🏝️ Benefits

• Medical, vision, and dental coverage with low employee premiums.

• Voluntary benefit options, including pet insurance.

• Life and disability insurance.

• Retirement plans, including a 401K employer match and a pension plan that vests after 3 years of service.

• Wellness incentives and mental health resources, including counseling, stress management, and mindfulness programs.

• Generous paid time off.

• Tuition assistance for both undergraduate and graduate degrees.

• Employee recognition program.

• Commuter benefits.

• Free, convenient on-site parking.

• Subsidized on-campus cafes.

• On-site health and wellness activities.

• Fitness and well-being center offering in-person and virtual workouts along with nutritional counseling.