Claims Analyst I

Assurity • Lincoln, NE

7d • Hybrid

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

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

• Process health claims, which may include: 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; and 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.
• Performs other functions as assigned, which may include: Answering calls referred from Contact Center; Helping train new associates.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree