Entry Level Claims Examiner (Dental, Vision & Hearing)

ManhattanLife Insurance & Annuity Company•Houston, TX

3d•Hybrid

About The Position

ManhattanLife is seeking a Claims Examiner for our Dental, Vision & Hearing team. They will support our organization’s Claims team. Claims Examiners evaluate and process claim submissions. They also provide customer service to our policyholders over the phone.

Requirements

High School diploma or equivalent (GED).
Solid knowledge of ICD-9, ICD-10 or medical coding.
Excellent phone skills and an ability to communicate in a friendly and effective manner with our customers.
Understanding of basic medical terminology.
Ability to work independently and in a team environment.
Ability to prioritize and manage workload to meet deadlines.

Nice To Haves

1+ years of claims experience preferred.
Background in insurance claims is preferred in any discipline of Medicare Supplement, Dental, Vision & Hearing, Cancer, Home Healthcare, Short Term Care, or Disability.

Responsibilities

Analyze claims based on all claim documentation received and provide timely follow-ups for claims being adjudicated.
Process and resolve insurance claims in accordance to claim procedures, policy provisions and limitations, policy application, underwriting guidelines, medical conditions, company philosophy and state insurance laws.
Make decisions and ensure the successful resolution of inquiries and complaints by preparing accurate and timely activity reports.
Correspond with insured, doctors, hospitals, and other third parties to collect data.
Process payments.
Explain decisions to customers through appropriate communication channels.
Communicate via written correspondence or e-mail to claimants.
Confirm the validity of the contract between the company and Policy-owner on Agency issued contracts, process policy amendments or rescissions when necessary.