The Claims Examiner is responsible for the accurate and timely review and adjudication of long-term care claims according to policy and regulatory guidelines. This role involves processing payments or denials, managing inbound claim calls, and maintaining professional correspondence with stakeholders.
The Intake Specialist provides customer service by responding to telephone inquiries from policyholders, providers, and agents regarding insurance policies and claims. They are responsible for accurately updating software systems, maintaining company records, and ensuring compliance with privacy and confidentiality regulations.
The representative will handle incoming telephone inquiries from policyholders, providers, and agents regarding insurance policies and claims. They are responsible for accurately updating software systems, researching records, and providing timely follow-up on all customer requests.
The specialist is responsible for reviewing long-term care insurance policy eligibility and determining benefit approvals or denials. They must also manage claimant assessments, maintain accurate system records, and communicate professionally with stakeholders regarding claim status.
The Claims Examiner is responsible for adjudicating health and accident claims while managing outbound calls to resolve inquiries. They must prioritize tasks to meet turnaround times and ensure all actions comply with company and HIPAA regulations.
The representative will handle incoming telephone inquiries from policyholders, providers, and agents regarding insurance policies and claims. They are responsible for accurately updating software systems, maintaining product knowledge, and ensuring compliance with privacy regulations.
The role involves facilitating finance activities, including processing payments via Bank Lockbox and managing mailroom tasks. The analyst is responsible for verifying invoice accuracy, researching cash outages, and completing monthly financial reporting.
The Customer Support Representative manages client usage and compliance of EVV and facility platforms while providing troubleshooting and retraining support. They are responsible for maintaining accurate documentation and ensuring the compliant delivery of invoices to insurance carriers.
The Claims Examiner is responsible for the accurate and timely adjudication of long-term care insurance claims in compliance with policy and regulatory standards. This includes analyzing claim documentation, coordinating benefits, and communicating determinations to policyholders and providers.
Perform quality reviews of policy administration and claim transactions to ensure accuracy and compliance with standard operating procedures. This includes reviewing benefit eligibility, documenting errors, and reporting quality results to management and clients.
Perform quality reviews of LTC insurance operational and claim transactions to ensure accuracy and adherence to standard operating procedures. Responsible for reviewing benefit eligibility, documenting errors, and reporting quality results to management and clients.
Provide seamless support and training to clients using EVV and Facility platforms to ensure compliance and system efficiency. Manage inquiries from claimants, caregivers, and agencies to facilitate accurate invoicing for LTC insurance carriers.
The specialist will analyze business and EVV data to create insightful reports, dashboards, and BI solutions to support decision-making. They are responsible for monitoring compliance risks, identifying trends, and collaborating with stakeholders to optimize reporting workflows.
