Analysis Skills, Brokerage, Case Management, Claims Processing, Communication Skills, Customer Escalations, Customer Relations, Customer Support/Service, Data Analysis, Data Collection, Documentation, Insurance Claims, Interpersonal Skills, Presentation/Verbal Skills, Problem Solving Skills, Resolve Customer Issues, Risk Management, Time Management, Writing Skills
Pay Rate: $50 per hour
Work Mode: Fully Remote
Summary:
- Part Time
- 20 hours per week
- Availability needed during core workdays and hours: Monday – Friday, 7:00AM – 5:00PM local time
- Must be available to work EST hours during training
Responsibilities:
- Effectively manage an assigned caseload of moderately complex claims with some level of oversight.
- Provide timely, balanced, and accurate claims reviews, documentation, and recommended decisions.
- Communicate proactively with claimants and/or their representatives, demonstrating empathy and active listening.
- Document conversations within claim files in a timely manner with appropriate detail and professional writing skills.
- Interact and communicate effectively with claimants, customers, attorneys, brokers, and family members during claim evaluations.
- Compile file documentation and correspondence requiring extensive policy and factual detail.
- Collaborate with external and internal resources to gather necessary data for claim evaluations.
- Clarify and reconcile inconsistencies during claim evaluations and collaborate with Fraud Waste and Abuse resources as needed.
- Calculate monthly benefits due after elimination period, including Client, Social Security Offsets, and Rehab Return to Work benefits.
- Provide timely and detailed written communication during the claim evaluation process.
- Address and resolve escalated customer complaints in a timely and thorough manner.
Requirements:
- Minimum 3 years of LTD/IDI Insurance Claims experience.
- Experience with independent judgment and decision-making based on available facts.
- Demonstrated use of critical thinking and analysis when reviewing information.
- Creative problem-solving abilities and the ability to think outside the box.
- Excellent interpersonal and communication skills in both verbal and written form.
- Excellent customer service skills proven through internal and external customer interactions.
- Demonstrated conceptual thinking, risk management, and ability to handle complex situations effectively.
- Organizational and time management skills.
- Bachelor’s degree.
A
Axelon Services Corporation