Claim Approver

The Claim Approver is a role in a high-energy, fast-paced, changing environment.

The Claim Approver will provide customer centric service processing entry-level claims including payment, denial and status updates. Performs assigned tasks within the Claims department in accordance with established procedures and guidelines while developing the skills and knowledge required for adjudicating more complex claims as needed.

The Claim Approver would be expected to be able to communicate simple status and claim information to customers, both verbally and in writing.

Responsibilities

• Develop the ability to work effectively with the policyholders
• Accurately process claims under supplemental coverage
• Reviews and processes claims on supplemental coverage according to Company procedures, policies and appropriate state regulations
• Request additional information from policyholders, providers and others as necessary to finalize claim
• Provide customer service to internal and external customers by answering questions both in writing and by phone.
• Meet department standards for time service and quality
• Develop customer and product knowledge to manage claim / call handling policies, procedures, processes and tools as well as Claims competencies
• Understand organizational objectives, support process improvements, and provides feedback to leadership
• Participate in required training
Perform other duties as assigned

Skills

• Ability to work in a fast-paced, ever-changing environment
• Ability to manage competing priorities
• Strong organizational skills with attention to detail
• Excellent written and verbal communication skills
• Quality and customer centric orientation
• Analytical with good decision- making skills
• Medical terminology knowledge
• Navigation between systems and use of technology is important
Proficient in MS office-Outlook and

Education and Experience

• College degree preferred
• 2 plus years of customer experience or claims experience