* Short Term Disability Claims Experience Required*
When it comes to making a meaningful difference in the lives of our customers and employees, USAble Life is always ready. We are a diverse group of individuals working together to go the extra mile. Through our DEI initiatives, employees feel empowered to bring their talents and voice to our culture.
Our passion for delivering the best products is matched only by our passion for our people. We are committed to making a meaningful difference in the lives of others which extends beyond our office walls. USAble Life has a long tradition of supporting our communities, and we’re proud of the fact that our employees share that commitment.
We have been recognized as a “Best Places to Work” in Arkansas, Florida, and Hawaii. You’ll be rewarded with opportunities for personal and professional development and opportunities for advancement. This, coupled with our engaging culture and a comprehensive benefits package, ensures we are committed to our employees.
Check out how we make a meaningful difference in the lives of others!
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What We Offer You:
- A culture that values employees and celebrates, empowers, and inspires a diverse workforce
- Outstanding and affordable benefits package
- Yearly bonus potential and annual increases
- PTO provided at date of hire
- 11 paid holidays
- 401(k) with up to 6% match; fully vested from day 1
- Remote opportunities with company-provided equipment
- Team-oriented, collaborative group of peers
- Career advancement opportunities
- Tuition Reimbursement
- Employee Assistance Program
- Inclusion Council and Employee Resource Groups
- Recharge Days and Volunteer Time Off
- This is a remote position.
The base salary range for a Claims Examiner I is $39,000 to $58,000. The base salary range for a Claims Examiner II is $44,000 to $65,000. The base salary range for a Sr. Claims Examiner is $49,000 to $73,000. Actual salaries will vary by geographic location and are based on factors such as candidate’s qualifications, experience, skills, competencies, and company tenure and equity. In addition to base compensation, this role is eligible for an annual incentive plan based on company performance and individual performance.
This is a multi-level position with increasing levels of responsibility with each position.
A Claims Examiner I will:
- Perform diverse duties relating to the processing, review and adjudication of claims; including reviewing for accuracy, file and claim completeness, reviewing coverage and approving payment or denial.
- Work in a training and learning capacity in conjunction with a more senior Claims Examiner until fully competent to independently receive claims documents.
- Communicate with claimants, group policy holders, medical providers and internal staff on claims related issues.
- Update tracking systems and processing systems as necessary.
Essential Duties:
- Review claim information for accuracy, completeness and coverage in force.
- Contacts claimants, group policyholders or medical providers for additional information.
- Compose and prepare correspondence to insureds, groups, beneficiaries and physicians.
- Provide complete and thorough file documentation including detailed explanations, recommendations, and documentation of actions taken.
- Analyze data and adjudicate claims in accordance with policy provisions.
- Maintain workload inventory on a daily basis. May perform other duties as assigned.
Required Knowledge, Skills, and Abilities:
- Experience working Short Term Disability Claims
- Knowledge of diagnosis and procedure codes and general medical terminology
- Proficient in MS Office
- Excellent verbal and written communication skills including professional telephone skills and the ability to compose professional correspondence
- Demonstrated leadership skills and the ability to assist and guide others
- Attention to detail and ability to maintain a low error rate
- Organization skills
- Ability to prioritize tasks, critical thinking, multi-task and handle deadlines.
Required Education and Experience:
- Associates degree or equivalent professional experience
- 1 to 3 years customer service experience
Preferred Education and Experience:
- Bachelor's Degree
- LOMA courses 280/281 and 290/291
- Medical coding experience
A Claims Examiner II Essential Duties:
- Reviews claims with increasing complexity information for accuracy, completeness and coverage in force.
- Contact claimants, group policyholders or medical providers for additional information.
- Compose and prepare correspondence to insureds, groups, beneficiaries and physicians.
- Provide complete and thorough file documentation including detailed explanations, recommendations, and documentation of actions taken.
- Perform claim file set-up.
- Enter information into claims processing system.
- Maintain workload inventory on a daily basis. May perform other duties as assigned.
Required Knowledge, Skills, and Abilities:
- Experience working Short Term Disability Claims
- Knowledge of diagnosis and procedure codes and general medical terminology
- Proficient in MS Office
- Excellent verbal and written communication skills and ability to compose professional
correspondence - Demonstrated leadership skills and the ability to assist and guide others
- Attention to detail and ability to maintain a low error rate
- Organization skills
- Ability to prioritize tasks, critical thinking, multi-task and handle deadlines
Required Education and Experience:
- Associates Degree or Equivalent professional experience
- 1 to 3 years customer service experience
- 1 to 3 years as a Claims Examiner
Preferred Education and Experience:
- Bachelor's Degree
- LOMA courses 280/281 and 290/291
- Experience with FINEOS or other claims system
A Claims Examiner Sr. Essential Duties:
- Review claims with the most complexity for information for accuracy, completeness and coverage in force.
- Contact claimant, group policyholder or medical provider for additional information.
- Analyze data and adjudicate claims in accordance with policy provisions.
- Provide complete and thorough file documentation including detailed explanations, recommendations, and documentation of actions taken.
- Compose and prepare correspondence to insureds, groups, beneficiaries and physicians.
- Provide mentoring and coaching to other team members and new employees.
Required Knowledge, Skills, and Abilities:
- Experience working Short Term Disability Claims
- Knowledge of diagnosis and procedure codes and general medical terminology
- Proficient in MS Office
- Excellent verbal and written communication skills and ability to compose professional
correspondence - Demonstrated leadership skills and the ability to assist and guide others.
- Attention to detail and ability to maintain a low error rate
- Organization skills
- Ability to prioritize tasks, critical thinking, multi-task and handle deadlines.
Required Education and Experience:
- Associates Degree or equivalent professional experience; LOMA 280/281 and 290/291 within 18 months of hire to position
- 3 to 5 years claims experience
Preferred Education and Experience:
- Bachelor's Degree in a business related field; LOMA courses 280/281 and 290/291
- 3 or more years of insurance industry experience; experience with FINEOS or other claims system
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