Job Description:

Summary

Processes highly complex claims to ensure accurate and timely processing. Leads and oversees the work of others.

Essential Job Functions

• Conducts correspondence related to client requests for information.
• Evaluates available information to validate claims. Verifies policyholder information, policy effective dates, premium status and verification of claim eligibility.
• Identifies need for additional information; contacts appropriate source to obtain needed information. Verifies beneficiary or claimant information if claim is warranted. Identifies payment amount and obtains required management approvals for payment. Processes payment.
• Investigates highly complex claims and determines level of resolution if appropriate; advises claimant of status; negotiates settlement and resolution of claim.
• Receives demand letters; researches and investigates claims, responds within individual parameters and escalates as appropriate.

Basic Qualifications

• High school diploma or G.E.D.
• Fellowship of Life Health Claims (FLHC) Certification preferred
• Six or more years of insurance/claims processing experience
• Experience working with insurance and/or medical terminology
• Experience working with appropriate claims processing procedures and documentation

Other Qualifications

• Strong analytical and problem solving skills
• Strong interpersonal skills to interact with team members
• Strong communication skills to communicate with clients
• Strong negotiation skills to interact with claimant
• Good human relations skills to provide leadership and work guidance to less experienced personnel
• Ability to keep sensitive and confidential material private
• Ability to work in a team environment

Work Environment

• Office environment

If you are an applicant from the United States, Guam, or Puerto Rico

DXC Technology is an Equal Opportunity/Affirmative Action employer. All qualified candidates will receive consideration for employment without regard to disability, protected veteran status, race, color, religious creed, national origin, citizenship, marital status, sex, sexual orientation/gender identity, age or genetic information. DXC's commitment to diversity and inclusive selection practices includes ensuring qualified long-term unemployed job seekers receive equal consideration for employment. View postings below.

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