Medicare Supplement Claims Specialist chez Everence

POSITION SUMMARY
Review health claims for the Medicare Supplement line of business. Interact with internal and external customers to answer questions, resolve issues, and address concerns while maintaining a professional image through excellent telephone etiquette and top-notch customer service.

RESPONSIBILITIES AND DUTIES

1. Approve or reject health claims according to Everence’s policy and certificate guidelines.
2. Complete data entry into Group+ to adjudicate claims charges.
3. Perform appropriate correspondence via letter or telephone for claim completion.
4. Answer inquiries regarding eligibility and confirmation of benefits for coverage of proposed services for Medicare Supplement plans.
5. Answer inquiries regarding the status of claims payment for Medicare Supplement plans.
6. Document all customer service contacts.
7. Perform other duties and assignments as requested by the manager.

QUALIFICATIONS

Education: 
High School graduate preferred

Experience: 
Medical or insurance background is desirable

Skills and Abilities:

1. Excellent verbal and written interpersonal and communication skills, including advanced listening skills.
2. Customer-focused with the ability to adapt and respond sensitively to various customer types
3. Demonstrates positive leadership skills and takes initiative
4. Ability to make quick and appropriate decisions despite interruptions
5. Flexibility in adapting to changing work patterns and fluctuating workloads
6. Excel at problem solving
7. Strong attention to detail with the ability to multitask and prioritize while managing time efficiently
8. Skilled in using Microsoft Office software
9. Ability to cultivate and sustain a strong sense of teamwork 

SUPERVISORY RESPONSIBILITIES: None
SCHEDULE: Full-time