Assistant Claim Examiner at Healthcare Risk Advisors

Healthcare Risk Advisors is seeking an Assistant Claim Examiner (ACE) to join our claims operations team. This position assists in the litigation, investigation and disposition of claims and lawsuits and coordinates communication to insured client hospitals, physicians and carrier representatives. In addition, the ACE ensures the data accuracy of claim information in Oasis and OnBase.

Qualifications:

• Bachelor’s degree preferred.
• Knowledge of litigation process. 

Responsibilities:

Service/Support Delivery

• Provides clear communication with insureds and follows up as necessary based on expectations agreed to with the client. 
• Maintains a broad-based understanding of the company standards and guidelines
• Articulates the guidelines to both internal and outside customers as necessary
• Seeks to actively meet the expected standards and guidelines in all phases of their work product
• Uses appropriate judgment in applying guidelines to achieve the desired outcome

 Policy/ Procedure Development and Compliance

• Complies with all established policies and procedures for the team.  
• Identifies and elevates potential areas for improvement and service enhancements. 
• Actively remedies compliance issues as identified by management.    

 Claims Guidelines

• Maintains a broad-based understanding of the company standards and guidelines. 
• Articulates the guidelines to both internal and outside customers as necessary. 
• Seeks to actively meet the expected standards and guidelines in all phases of their work product. 
• Uses appropriate judgment in applying guidelines to achieve the desired outcome. 
• Ensures submitted reports are formatted, finalized, distributed, and uploaded. 

 Report and Data Maintenance

• Enters accurate information and maintains accuracy.

Technical Knowledge and Professional Development

• Completes any training required to maintain or advance the skills set necessary to achieve professional, department, or company goals

Other Duties as Assigned

• Assists with a variety of department and company-wide projects.
• Makes oneself available for any and all duties.
• Accepts delegated tasks readily and completes assigned duties as directed.

Salary Range: $55,301 - $72,582

Compensation varies based on skills, knowledge, and education. We consider factors such as specialized skills, depth of knowledge in the field, and educational background to ensure fair and competitive pay.

Benefits:

Healthcare Risk Advisors offers competitive compensation, outstanding career opportunities, an exceptional work environment, and an impressive benefits package, which starts with medical, family and bereavement leave; same-sex domestic partner benefits; short- and long-term disability programs; and an employee assistance program. There's more:

• Health, dental, and vision insurance
• Health and dependent care tax-free spending accounts with a company match
• 401(k) and Roth IRA with company match, as well as catch-up plans for both
• Paid vacation, sick days, and personal days each calendar year (with vacation increases based on length of service)
• 11 paid holidays each calendar year
• Life and travel insurance
• Tax-free commuter benefits
• In-person and online learning opportunities
• Cross-function career opportunities
• Business casual work environment
• Time off to volunteer
• Matching donations to qualifying nonprofit organizations
• Company-sponsored participation at non-profit events