What are the responsibilities and job description for the Claims Analyst position at Aston Carter?
Description:
The ability to review proofs of loss quickly, ensure claims are administered in accordance with policy provisions and the company’s practices and philosophy, and work well with others. This requires a detail-oriented mind set, critical thinker who is willing to take initiative and work consultatively with others. This person will work effectively and efficiently to meet expected turnaround times. We look for our claim examiners to be analytical and provide prompt, fair payment of all legitimate claims.
Essential Job Duties:
1. Answer and respond to inbound telephone inquiries from policy beneficiaries, or their representatives, and provide excellent service during their claims inquiries
2. Strategic thinking and decision-making skills.
3. Ability to work well in a team based environment
4. Maintains an excellent attendance record
5. Review policy contracts and determine if coverage is applicable
6. Review and prepare claims for processing; maintain claims information in the claims app
7. Determines base payment by referring to policy coverage and limits, and determines course of action (i.e., payment, further investigation or denial)
8. Maintain the assigned follow ups and pending inventory
9. Cross train on various product processing within the claims department
10. Correspond with agents, policyholders, hospitals, doctors, attorneys, beneficiaries and claimants for information regarding the claim
11. Correspond with customers for resolutions of concerns through outgoing calls or written communications
12. Process verifications and manage the verification inventory
13. Assess, research and correct claims discrepancies, collaborate with other members of the team as needed.
14. Comply with HIPAA and other privacy regulations.
15. Maintain complete confidentiality of company business.
16. Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
17. Participation in educational seminars, webinars, and local claims meetings.
18. Approval limit will vary with experience level
a. Based on experience could be approved to release up to $1000 without secondary review
b. Have release authority no more than $10,000
Skills & Qualifications:
-1-2 years of claims experience
-Ability to research claims
Shift:
1st shift M - F
About Aston Carter:
Please Note: Scammers are posing as Aston Carter. We'll never contact you via Gmail, Telegram, or WhatsApp and we'll never solicit money from you.
At Aston Carter, we’re dedicated to expanding career opportunities for the skilled professionals who power our business. Our success is driven by the talented, motivated people who join our team across a range of positions – from recruiting, sales and delivery to corporate roles. As part of our team, employees have the opportunity for long-term career success, where hard work is rewarded and the potential for growth is limitless.
Established in 1997, Aston Carter is a leading staffing and consulting firm, providing high-caliber talent and premium services to more than 7,000 companies across North America. Spanning four continents and more than 200 offices, we extend our clients’ capabilities by seeking solvers and delivering solutions to address today’s workforce challenges. For organizations looking for innovative solutions shaped by critical-thinking professionals, visit AstonCarter.com. Aston Carter is a company within Allegis Group, a global leader in talent solutions.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888-237-6835 or email astoncarteraccommodation@astoncarter.com for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.
Salary : $20 - $22
