Accident and Health Claims Examiner

Brown & Brown Insurance

10d•$18 - $19•Onsite

About The Position

One80 Intermediaries is seeking an Accident and Health Claims Examiner to join their growing 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.

Requirements

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.

Responsibilities

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 an overflow for the CSR team.