Voluntary Benefits Claims Examiner
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About The Position
The Voluntary Benefits Claims Examiner will support a large Group Insurance Business contract and is responsible for the calculation of Voluntary Benefits across limited products according to Plan Provisions. Voluntary Benefits can include wellness, hospital indemnity, accident, and critical illness products. This position requires knowledge and understanding of Voluntary Benefits policies and procedures with a medical terminology background and the ability to read medical records outside of ICD's, CPTs, and HCPC to appropriately calculate the benefits due. You will be expected to follow through timely on claim processing, utilize judgment, and assess risk when rendering claim decisions. You should be able to communicate with various constituents with limited guidance and learn and transact using the client’s systems. Expected to communicate clearly and concisely to influence return to work, discuss terms of the certificate, and the basis of payment or nonpayment.
