Insurance Claims Examiner (Dental, Vision & Hearing)

ManhattanLife Insurance & Annuity Company • Houston, TX

10d

About The Position

ManhattanLife is seeking a Claims Examiner for our Dental, Vision & Hearing team. They will support our organization’s Claims team. Claims Examiners evaluate and process claim submissions. They also provide customer service to our policyholders over the phone.

Requirements

• High School diploma or equivalent (GED).
• 1-3 years of claims experience preferred.
• Solid knowledge of ICD-9, ICD-10 or medical coding.
• Excellent phone skills and an ability to communicate in a friendly and effective manner with our customers.
• Background in insurance claims is preferred in any discipline of Medicare Supplement, Dental, Vision & Hearing, Cancer, Home Healthcare, Short Term Care, or Disability.
• Understanding of basic medical terminology.
• Ability to work independently and in a team environment.
• Ability to prioritize and manage workload to meet deadlines.

Responsibilities

• Analyze claims based on all claim documentation received and provide timely follow-ups for claims being adjudicated.
• Process and resolve insurance claims in accordance to claim procedures, policy provisions and limitations, policy application, underwriting guidelines, medical conditions, company philosophy and state insurance laws.
• Make decisions and ensure the successful resolution of inquiries and complaints by preparing accurate and timely activity reports.
• Correspond with insured, doctors, hospitals, and other third parties to collect data.
• Process payments.
• Explain decisions to customers through appropriate communication channels.
• Communicate via written correspondence or e-mail to claimants.
• Confirm the validity of the contract between the company and Policy-owner on Agency issued contracts, process policy amendments or rescissions when necessary.

Benefits

• ManhattanLife offers attractive employee benefits starting day one, including immediate coverage under our health, dental and vision plans.
• We offer flexible schedules, including shortened hours on Fridays, free parking, company-wide events, professional development (LOMA testing) and a company-wide wellness program.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED