[Hiring] Claims Administrator I @Aquent

Role Description

Step into a pivotal role as a Case Specialist, where your expertise will directly impact the well-being of clients by ensuring timely and accurate resolution of short-term disability claims. You will be at the heart of service delivery, making critical decisions that provide peace of mind and essential support during challenging times. This fast-paced and exciting environment offers the chance to work autonomously while being an integral part of a collaborative team, contributing significantly to client satisfaction and the organization's commitment to excellence.

What You'll Do

• Work both independently and collaboratively to deliver exceptional service to clients and claimants.
• Review claims thoroughly and make final determinations regarding benefit approval or denial.
• Authorize claim payments within established limits, leveraging appropriate guidelines.
• Evaluate duration guidelines and recommendations from clinical and vocational resources to determine the correct disposition of claims.
• Document and act on strategic assessments to ensure claims are adjudicated efficiently and accurately.
• Interpret contracts to ensure fair and consistent claims practices, adhering to all relevant laws, regulations, and procedures.
• Gather necessary supporting documentation to substantiate disability claims and communicate effectively with employers, claimants, physicians, attorneys, and other relevant parties.
• Contribute to other related duties, such as supporting claims staff or assisting with special projects, as business needs arise.

Qualifications

• Strong mathematical aptitude for precise calculations and claim payments.
• Excellent judgment and decision-making skills to adjudicate claims in line with policy provisions.
• Proven ability to comprehend and interpret legal and medical terminology for claim decisions.
• Exceptional organizational skills and the capacity to effectively manage multiple tasks.
• Ability to communicate effectively with internal and external contacts while handling highly confidential information.
• A strong client service focus, always seeking solutions.
• Effective analytical and problem-solving capabilities.
• Resilience and adaptability to thrive in a fast-paced and demanding environment.
• A track record of successful autonomous work alongside effective team collaboration.
• Outstanding written and verbal communication skills.
• Strong interpersonal skills.
• Demonstrated ability to meet deadlines with a high degree of accuracy and attention to detail.
• 1+ years of experience in customer service or financial services.
• Proficiency in end-user computing, including MS Office Outlook, Word, and Excel.
• A quick learner with the ability to master various computer applications.

Bonus Points

• Associate or Bachelor degree.
• Prior claim management experience.