Claims Specialist 1-Remote
About The Position
Wellabe is looking for a Claims Specialist 1 to join our team. The Claims Specialist 1 is responsible for processing, reviewing, and adjusting routine life or health claims. Someone in this role will review, analyze and process claims, adjustments, coordination of benefits and refunds on routine life or health claims including accurate entry of codes and data to applicable system. Work may be reviewed for accuracy and more complex claims referred to a more experienced specialist. Life - responsible for final expense or preneed products. Health - responsible for Medicare Supplement, Dental or Hospital Indemnity or other related products. Respond to general inquiries by agents, policyholders, and providers concerning policy coverage and other related information by phone, email, letter or other communication channels. Health - Cross train on one or more other products and/or back up medical records, transmittal, provider files or other related duties.
Requirements
- General knowledge of the principles, processes, and practices related to claims processing including local, state, and government insurance-related policies.
- Strong verbal and written communication skills.
- Intermediate computer skills with basic knowledge of MS Office Suite (Excel, Word, and PowerPoint).
- Ability to meet or exceed all procedural, financial and quality metrics including production standards, adjudications, quality, state and federal compliance regulations, etc.
- Acts in accordance with all HIPAA Privacy and Security guidelines to ensure confidential handling of protected health information.
- High school diploma or GED equivalent.
Nice To Haves
- Previous related experience, a plus.
Responsibilities
- Review, analyze and process claims, adjustments, coordination of benefits and refunds on routine life or health claims including accurate entry of codes and data to applicable system.
- Respond to general inquiries by agents, policyholders, and providers concerning policy coverage and other related information by phone, email, letter or other communication channels.
- Cross train on one or more other products and/or back up medical records, transmittal, provider files or other related duties.
Benefits
- Hybrid availability
- 401(k) with company match
- Health insurance
- Paid time off, holidays
- Volunteer time off
- Lifestyle Spending Account (LSA)
- Paternity leave
- Growth opportunities
- LinkedIn Learning Premium access
- CliftonStrengths® assessment and coaching
- On-site and virtual workshops and cohorts featuring world-class content from FranklinCovey, Crucial Learning, Gallup, and more
- Free world-class insurance acumen courses through AHIP and LOMA
- Reimbursement and bonus opportunities for professional designations and certifications, including a tuition reimbursement program
- Opportunities to take part in Wellabe's mentorship programs
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
