Claims Examiner, Assistant

Description:
Processes less complex or small standard claims to ensure accurate and timely completion.

Requirements

What You Will Do:

Enters insurance claims received electronically or in written form.

Answers incoming customer calls regarding claim processing.

Documents claim and associated history.

Evaluates available information to validate straightforward basic claims.

Verifies policyholder information, policy effective dates, premium status and verification of claim eligibility.

Sends claim form to claimant for updating, correction or completion.

Identifies need for additional information; contacts appropriate source to obtain needed information.

Verifies beneficiary or claimant information if claim is warranted.

Identifies payment amount and obtains required management approvals for payment.

Advises claimant of status and resolution of claim.

Escalates claimant concerns as appropriate.

About the Company

Quant Dynamics Solutions is consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve our most complex business challenges.