Rep Benefit Adjuster V DI

Profile

*Evaluates, process, manages and/or audits advanced and highly complex claims with the potential for high financial impact which requires advanced judgement and investigation such as Long Duration Disability claims requiring active and ongoing claim management in accordance with Company policy terms, insurance laws, regulatory requirements and adjusting/claim management guidelines or Stop Loss claims requiring broad knowledge of multiple insurance sector benefits eligibility.

*Provides appropriate verbal and/or written communication to internal and external Customers in a positive and knowledgeable manner to ensure a high standard of Customer service. Meets standards established in department performance metrics for appropriate handling of Customer phone calls.

*Acts as a direct contact and communicate with internal and external Customers and medical providers in a positive, knowledgeable and professional manner, providing them with direction and assistance in all facets of insurance coverage and needs.

Requirements:

Prompt and reliable

Advanced knowledge of medical terminology

Proficient with PC Windows-based software, including Microsoft Office

Easily adapts to new software/technology applications and is able to excel in a paperless environment

Advanced knowledge of anatomy and physiology

Advanced contract knowledge

Advanced familiarity with CPT and ICD-10 coding

Possesses high degree of decision making ability

Strong research and analytical skills

Flexible work schedule, including willingness to work overtime as needed

Strong communication skills, both verbal and written

Ability to handle fast-paced environment

Professional attitude

Dedicated to providing world-class Customer service

Exceptional disability claim management knowledge

Ability to work well within a team environment

Company info

American Fidelity Assurance Company
Website : http://www.afadvantage.com