Claims Service Specialist

ARAG North America • Des Moines, IA

3h • Onsite

About The Position

ARAG is hiring a Claims Service Specialist! This person will examine, research, and process claims within a designated timeframe. The ability to effectively prioritize workload, meet deadlines, and maintain accuracy in a fast-paced environment is required.

Requirements

• Knowledge of policy provisions as related to review of claims submissions and processing.
• Understanding of common legal matters, their processes and terminology.
• Knowledge of applicable privacy laws.
• Understanding of department functions as related to claims processing.
• Proficiency in MS Office and Adobe Acrobat Version 8.0 or better.
• Demonstrated ability to operate a variety of software applications in order to process claims.
• Proven attention to detail, including data entry and identification of exceptions to trends.
• Strong communication, analytical and problem solving skills.

Responsibilities

• Examines, researches and processes claims with proper application of ARAG policies and plan certificate language including: Reviewing claims rules results and documenting appropriate response.
• Approving or denying claims based on research conducted.
• Preparing written requests for additional information when needed.
• Processes claims within established performance standards, including turnaround time and Quality Assurance scores.
• Reviews and understands documents pertinent to claims processing including: claim forms, claims history, provider bills, communications from outside parties and various court documents and records.
• Engages in departmental discussions to improve processes and outputs.
• Documents claim records when needed with decision details.
• Serves as a positive role model by representing the ARAG at its Best and Leadership at its Best.
• Other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED