Claims Examiner

Company: Gainwell Technologies
Location: Little Rock
Posted on: January 12, 2021

Job Description:

Job Description:Essential Job Functions* 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 claims. Verifies policyholder information, policy effective dates, premium status and verification of claim eligibility.* Sends claim form to claimant for updating, correction or completion.* Investigates simple to moderately complex claims and determines level or resolution if appropriate; advises claimant of status; assists in negotiating settlement and resolution of claim.* 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. Processes payment.Basic Qualifications* High school diploma or G.E.D.* Fellowship of Life Health Claims (FLHC) Certification preferred* Two or more years of auditing, accounting, contracts or information technology experience* Experience working with insurance and/or medical terminology* Experience working with appropriate claims processing procedures and documentationOther Qualifications* Good analytical and problem solving skills* Good interpersonal skills to interact with team members* Good communication skills to communicate with clients* Good data entry skills* Negotiation skills to interact with claimant* Ability to keep sensitive and confidential material private* Ability to work in a team environmentWork Environment* Office environment

Keywords: Gainwell Technologies, Little Rock , Claims Examiner, Other , Little Rock, Arkansas