Claims Intake Specialist Insurance Claims Experience Required
Claims Intake Specialist Insurance Claims Experience Required
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Job Description
Required Qualifications
Graduate in any stream - Previous experience in an insurance claims backoffice role preferably within disability life or voluntary benefits is required.
- Understanding of medical terminology coding (ICD10 CPT) and insurance policies
- Proficiency with Microsoft Office Suite (Word Excel Outlook) and claims management software.
- Ability to work independently and manage multiple claims simultaneously.
- Knowledge of medical terminology and insurance terms is helpful.
- Ability to maintain confidentiality and manage sensitive information with discretion.
- Ability to adapt to changing procedures and workflows in a dynamic environment.
Preferred Qualifications
- Strong understanding of disability insurance processes claims management systems and regulatory requirements is a plus.
Skills
Effective Communications: Understanding of effective communication concepts tools and techniques; ability to effectively transmit receive and accurately interpret ideas information and needs through the application of appropriate communication behaviors.
Managing Multiple Priorities: Knowledge of effective selfmanagement practices; ability to manage multiple concurrent objectives projects groups or activities making effective judgments as to prioritizing and time allocation.
ABOUT EQUITABLE
At Equitable were a team committed to helping our clients secure their financial wellbeing so that they can pursue long and fulfilling lives..
We turn challenges into opportunities by thinking working and leading differently where everyone is a leader. We encourage every employee to leverage their unique talents to become a force for good at Equitable and in their local communities.
We are continuously investing in our people by offering growth internal mobility comprehensive compensation and benefits to support overall wellbeing flexibility and a culture of collaboration and teamwork.
We are looking for talented dedicated purposeful people who want to make an impact. Join Equitable and pursue a career with purpose.
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Equitable is committed to providing equal employment opportunities to our employees applicants and candidates based on individual qualifications without regard to race color religion gender gender identity and expression age national origin mental or physical disabilities sexual orientation veteran status genetic information or any other class protected by federal state and local laws.
NOTE: Equitable participates in the EVerify program.
If reasonable accommodation is needed to participate in the job application or interview process or to perform the essential job functions of this position please contact Human Resources ator email us at.
At Equitable our power is in our people.
Were individuals from different cultures and backgrounds. Those differences make us stronger as a team and a force for good in our communities. Here youll work with dynamic individuals build your skills and unleash new ways of working and thinking. Are you ready to join an organization that will help unlock your potential
Equitable is seeking a dynamic Claim Intake Specialist to join our Disability and Absence Claims organization. The Claim Intake Specialist is responsible for supporting the disability claims process by performing administrative and simple financial tasks ensuring accuracy and ensure smooth operations in the claims department. This role involves reviewing claim files validating information and supporting the claims team as required. The ideal candidate will have strong organizational skills attention to detail and the ability to work independently in a fastpaced environment.
Key Job Responsibilities
Claim Documentation Review:
- Review and verify the claims documentation including medical records claim forms and supporting paperwork are aligned with the applicable and appropriate claim.
- Ensure completeness of documentation before it is forwarded for claims adjudication.
- Coordinate with healthcare providers and claimants to obtain missing or additional information necessary to process claims.
- Research and resolve issues related to claims such as discrepancies or missing information by contacting claimants medical providers or other relevant parties as requested by claims specialist.
Data Entry & System Management:
- Input claim information accurately into the claims management system ensuring all details are captured for proper claims processing.
- Maintain accurate and uptodate claim records including claim status medical documentation and payment history.
- Track the progress of claims and ensure timely updates are made in the system.
Claims Verification & Validation:
- Assess the completeness of the claim files against policy requirements.
- Ensure claim materials are managed in compliance with company guidelines insurance regulations and state/federal laws.
- Validate medical certifications and supporting documentation to ensure the information provided meets the requirements of the original request.
Compliance & Confidentiality:
- Ensure compliance with all relevant laws policies and regulations concerning disability claims and sensitive personal information.
- Adhere to confidentiality protocols and maintain the privacy of claimant information.
- Stay informed about changes to disability insurance laws regulations and industry best practices.
Administrative & Reporting Support:
- Provide administrative support with documents as required by the claims department.
- Assist with the generation of monthly or quarterly claims reports tracking metrics and performance data.
- Perform additional administrative duties such as creating claim copies requesting additional information such as medical records reviewing claims files validating information filing and organizing claim records and supporting claims team as needed.
- Other duties as requested
Performance & Quality Assurance:
- Meet or exceed service targets including call resolution times customer satisfaction scores and other key performance indicators (KPIs).
- Participate in training and professional development programs to improve skills and knowledge.
- Meet or exceed performance metrics such as call resolution times customer satisfaction scores and adherence to schedules.
- Achieve and maintain required metrics and goals
- Work and partner with others within a teambased environment
The base salary range for this position is $41000 $55115. Actual base salaries vary based on skills experience and geographical location. In addition to base pay Equitable provides compensation to reward performance with base salary increases spot bonuses and shortterm incentive compensation opportunities. Eligibility for these programs depends on level and functional area of responsibility.
For eligible employees Equitable provides a full range of benefits. This includes medical dental vision a 401(k) plan and paid time off. For detailed descriptions of these benefits please reference the link below.
Equitable Pay and Benefits: Equitable Total Rewards Program
Required Experience:
Unclear Seniority
Employment Type
Full-Time
