Accident & Health Claim Examiner

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🕒 June 5

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One80 Intermediaries

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🤝 B2B

💸 Finance

🏢 Enterprise

B2B • Finance • Enterprise

One80 Intermediaries is a highly specialized wholesale brokerage and program manager that provides innovative and comprehensive insurance solutions across the US and Canada. The firm offers market-leading access to major insurance markets in the US, UK, Canada, and Asia, with exclusive programs and in-house binding authority for a variety of insurance lines, including property & casualty, financial lines, personal lines, life insurance, medical stop loss risks, travel/accident and health, executive benefits, affinity business, and warranty coverage. Through its team of experts and numerous offices, One80 serves commercial companies, non-profits, public entities, associations, unions, and private individual risks. The company is known for its expertise, speed, and innovation in creating tailored insurance programs and specialty services for a wide range of industry segments.

📋 Description

• Analyze and research claim issues of moderate to complex difficulty. • Ability to comprehend complicated workflows, policy certificates and policy provisions. • Review and apply policy provisions in processing of claims received. • Request and obtain necessary documents for claim processing/consideration, including scheduling follow ups for documentation. • Release of accurate benefit payments in accordance with CBP policy, industry standard & other applicable TPA or SLA agreements. • Proper documentation of required information in claim system, including follow up information. • Receive inbound calls within assigned queues and/or as overflow for the CSR team

🎯 Requirements

• High School Diploma or equivalent • Ability to function independently within established guidelines • Excellent interpersonal, oral and written communication skills • Intermediate skill level in Microsoft Office programs