Health Claims Processor

ManhattanLife Insurance & Annuity Company • Salt Lake City, UT

2d

About The Position

ManhattanLife is seeking a Claims Examiner to support our organization’s Utah team. Claims Examiners evaluate medical claims submissions, process the claims on our systems, and ensure data is entered into our system while keeping data up to date. Our Claims Processors also provide customer service to our policyholders over the phone.

Requirements

• High School Graduate or equivalent (GED)
• one year of business experience
• insurance knowledge preferred
• Type a minimum of 45 words per minute.
• Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
• Ability to make procedural decisions and judgements on sensitive, confidential issues.
• Ability to attentively take direction and execute tasks and changes from management for all processes and operations.
• Dependable and flexible.
• Computer literate; demonstrates proficiency in the use of Microsoft Word and Excel.
• Strong data and records management skills.

Responsibilities

• Review, reprice, and pay claims.
• Daily data entry of all claims for Medical, Home Health Care Prescription (HHC RX), Student Accident (SA), Cancer (CA), and Accident (AC) claims.
• Make customer service calls.
• Handle connections assigned.
• Follow up on all pending claims.
• Send out all claim forms related to Health, SA, CA, AC, HHC, HHC RX.
• Process returned mail.
• Send out explanation of benefits (EOB) to providers.
• Remain aware of any product system modifications and enhancements along with any procedural changes.
• Collaborate, coordinate, and communicate with departments within the company to ensure constant sharing of information and quality of service for our customers.
• Accurately determine claim benefits payable based on medical records, contract language, and any additional information needed to reach the appropriate decision in a timely manner. This includes both payment and denial of benefits.
• Complete special projects and tasks as assigned by management.

Benefits

• ManhattanLife offers attractive employee benefits starting day one, including immediate coverage under our health, dental and vision plans.
• We offer flexible schedules, including shortened hours on Fridays, free parking, company-wide events, professional development (LOMA testing) and a company-wide wellness program.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 101-250 employees