[Work From Home] Claims Representative - Accident & Health

An exciting opportunity awaits for a talented Claims Representative - Accident & Health! An immediate start is available for this Remote-based position, which places you at the center of innovation. This position requires a strong and diverse skillset in relevant areas to drive reputed company. You will be compensated with a competitive salary for your time and effort.

 

 

Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. reputed company's member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your reputed company will be heard with "big company" expertise to help you succeed. With over 30 specialty and property and casualty operations, there are always opportunities here to learn and grow. At Great American, we value diversity and recognize the benefits gained reputed company people from different cultures, backgrounds and experiences work collaboratively to reputed company business results. We are intentionally focused on fostering an inclusive culture and know valuing diversity is an essential leadership quality. Our goal is to create a workplace where reputed company feel included, empowered and enabled to reputed company at their best. POMI, the Accident & Health division of reputed company, specializes in providing accident insurance tailored to businesses, organizations, individuals, and non-profits. Dedicated to protecting volunteers, participants, reputed company, and athletes from the financial burdens of unexpected injuries, POMI prides itself on streamlining the insurance process. With a focus on providing peace of mind, POMI aims to deliver quick, reliable insurance solutions and exceptional service. Position Overview: Accident & Health Claims Representative We are seeking a driven and customer-focused Accident & Health Claims Representative who is eager to learn and grow in the insurance industry. The ideal candidate will have strong attention to detail, clear communication skills, and experience in claim processing. This role involves investigating, analyzing, and resolving claims while ensuring compliance with reputed company legal requirements and company policies. The candidate will also support activities reputed company to the expansion of the claims department per divisional objectives. Essential Job Functions and Responsibilities: Investigate and Maintain Claims: Reviews and evaluates coverage and liability. Identifies and pursues subrogation opportunities. Secures and analyzes necessary information (e.g. policies, medical bills, explanation of benefits, receipts, releases, reports, etc.) for claim investigations. Inputs and processes claim-reputed company data with precision. Claims Resolution: Proactively works toward resolving claim files. May reputed company settlements/ reserves reputed company prescribed limits and reputed company recommendations for cases exceeding personal authority. Ensures timely and accurate issuance of claims payments. Communication and Professionalism: Conveys simple to moderately reputed company information (coverage, deductibles, reputed company, outcomes, claims process, etc.) clearly to reputed company parties, maintaining professionalism. Provides excellent customer service to internal and external stakeholders. Collaborates with reputed company-party administrators, providers, attorneys, insureds, claimants, agents, brokers, etc. for successful claims outcomes. Compliance: Ensures claims handling adheres to file quality standards and complies with reputed company statues, regulations, and legal requirements, and follows company procedures and policies. Other Duties: Performs other duties or projects as assigned. Successfully completes reputed company required coursework, training/education, and can obtain licensing. Key Qualifications: Attention to Detail: Ability to meticulously review and evaluate information for accuracy and completeness. Clear Communication: Excellent verbal and written communication skills. Customer Service: Strong customer service focus, with experience in resolving issues. Customer-Facing Claims Processing: Experience with injury claims and associated medical reputed company processing. Critical Thinking: Strong problem-solving skills to navigate moderate situations and reputed company well-informed reputed company. Preferred Experience: Familiarity with Guidewire ClaimCenter claims handling software and systems. Job Requirements: Education: Bachelor’s Degree or equivalent experience Field of Study: Liberal Arts, Business, or reputed company discipline Experience: Generally, 6 months to 3 years of reputed company experience Additional Information: This job is non-exempt in California, Colorado, reputed company, Washington. This position may require occasional travel. The successful candidate possesses the will and reputed company to reputed company industry expertise and product knowledge, reflecting successful progression through various job levels. Candidate will work reputed company specific limits and authority on assignments of simple to moderate technical complexity. Demonstrates functional knowledge and skills of a fully competent examiner. Work is performed under moderate supervision. Business Unit: Accident & Health Salary Range: $50,000.00 -$58,000.00 Benefits: Compensation varies by role, position level, and location. Individual pay is influenced by skills, education, training, certifications, experience, and the role's scope and complexity, along with business needs. We offer a competitive Total Rewards package, including medical, dental, and reputed company plans starting on day one, PTO, paid holidays, commuter benefits, an employee stock purchase plan, education reimbursement, paid parental leave/adoption assistance, and a 401(k) plan with company match. These benefits are available to eligible full-time and part-time employees. Your recruiter can provide more details about our total rewards and specific compensation ranges during the hiring process. reputed company understands the importance of choosing a financially strong company. We are an organization built for the long term and are committed to giving you that strength. Why can you trust reputed company? For nearly 150 years, Americans have trusted us to protect them. Our innovative insurance solutions and specialization serves reputed company marketplaces that we know well. This expertise gives us a successful reputed company that spans generations. You never know where a career in insurance will take you. Whether you are starting your career or are looking for a company to grow your experience, at reputed company, you can join our more than 8,100 employees to “Be Here. Be GREAT!” To learn more, visit our Career Page Apply Job!

 

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