Location: Latham, NY
Our client is currently seeking a licensed NYS Independent Accident & Health Insurance Adjuster to take on the role of a Disability Claims Reviewer as the newest member of their team. The Claims Reviewer will be responsible for assessing benefits payable under disability contracts. This is a contract to hire position.
- Reviews and interprets disability contracts and medical information to determine employee eligibility, and benefit amount and duration.
- Certifies that claims meet the provisions of the contract.
- Acquires information needed to validate and adjudicate claims; makes outgoing calls to obtain information, performs investigations as necessary, handles claims status inquiries.
- Evaluates medical records in order to make actionable recommendations for the carrier. Proceeds as directed by carrier, consultant or policy terms for claims that require special handling.
- Assesses the existing processes and makes recommendations for improvement.
- Writes reports and correspondences as necessary.
- A minimum of an Associates Degree and 1 year of claims examining experience are required.
- Prior customer service experience is required.
- Must be willing to obtain a NYS Independent Accident & Health Insurance Adjuster license.
- Proficiency using Microsoft Office Suite software, Internet Explorer, Luminx and JMMAX.
- Excellent customer service and communication skills.
- Attentive to detail with the ability to multi-task.
If you are qualified for this position, please apply using our secure online form.