Claims Analyst I

Assurity•Lincoln, NE

About The Position

Assurity is looking for enthusiastic, driven and collaborative people to join our team. We’re a company of vibrant and passionate people who work every day to advance our mission of helping people through difficult times – and who truly want to make a difference. As a Certified B Corporation, we have a verified commitment to our people, community and planet, and we work every day to make the world a better place. Ample opportunities for growth, a thriving culture and coworkers who care as much as you do are just the beginning. Come work with purpose. Learn more: www.assurity.com/careers [http://www.assurity.com/careers]

Requirements

Four to six years’ relevant experience or equivalent required
Professional oral and written communication skills required
Consistent and reliable attendance is an essential function to this position
Decision-making ability required
Proficiency with word processing and spreadsheet software
Progress toward completion of ALHC and FLMI designations
Problem solving skills and appreciation for details required
Knowledge of LifePro and Workflow systems
Talent required in values, work intensity, achiever, positivity, resourcefulness, command, persuasion, relationship-extension, and exactness

Responsibilities

Initializing and triaging all claims for all health and disability products
Independently examine claims documentation such as medical bills/records, accident reports, claim forms and facility information (HCFA 1500 & UB04) and validate claims against policy coverage, state/federal regulations, and contractual requirements to determine correct claim process and decision
Serve as a liaison between numerous internal departments, including but not limited to customer service, accounting, legal, and others
Adhere to all statutory and regulatory fair claims practices
Making judgments within the standards of completeness, timeliness and accuracy regarding payment, denial, or investigation
Reading and analyzing medical records
Understanding and applying policy provisions
Composing and typing correspondence to policy holders, doctors, employers, and others as required
Calling claimants and/or employers for additional information
Ordering investigative reports, medical, financial, and other records as required
Paying ongoing/continuance claims within authority level
Referring continuance claims after 3 months of benefits have been paid to higher level
Processing continuance claims when referred back from higher level
Refers specified non-routine cases to Team Lead(s), Sr. Claims Supervisor, or higher level analysts
Answering calls referred from Contact Center
Helping train new associates