Health and Benefits Claims Specialist
2 weeks ago
**Description**:
As **H&B Claims Specialist**, you will work to manage and monitor client’s claims submissions and claims pre-approvals. You will be in day to day communication liaison with Consultants, Clients, Client Members, Insurers, and Third Party Administrators
**Role**
- Conduct regular clients visits to collect and review claims and discuss any issues related to claims.
- Gathers and reviews loss information and prepares claim status reports.
- Responds to and advocates on claims, coverage and eligibility questions from clients
- Collects, reviews and records rejections and settlements
- Acts as a liaison between carriers and clients, addressing service issues and monitoring for trends.
- Develops and fosters positive relationships with clients and carriers
- Acts as a referral point and mentor for the team
- Identify areas of for improvement in claims processes leading to efficiencies
**Qualifications**:
**Requirements**:
- Bachelor’s degree of any discipline preferably medicine / Pharmacy
- Computer literacy
- Working knowledge of Excel, MS Project, MS Word
- Claims system experience preferred
- Knowledge of the Market Service Organizations (MSOs) such as adjusters, accountants and other experts likely to be appointed by carriers.
- Minimum 2 years experience of insurance claims handling or advocacy.
- Knowledge of specific claims area.
**Application Process**
- Stage 2 Live video interviews with hiring managers
- Stage 3: Offer and onboarding
WTW is an equal opportunity employer
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