Life Claims Specialist

2 days ago

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AGIA Affinity

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AGIA Affinity is a company that develops, markets, and administers innovative benefit programs aimed at helping organizations engage and retain their customers, members, or employees. With a rich history spanning nearly 70 years, AGIA is known for offering unique solutions and hassle-free program management that drives revenue and enhances company culture. They leverage modern technology to automate processes, providing seamless digital customer experiences while also targeting improved engagement and incremental revenue growth for their clients.

EA+ • Affinity groups • Rescue 360 • Worldwide Rescue and Security • Device Guard

201 - 500 employees

🤝 B2B

💳 Fintech

⚕️ Healthcare Insurance

📋 Description

• Claims Specialist I is responsible for analyzing and adjudicating claims for group Life and Accidental Death insurance plans. • Research submitted claims and records regarding eligibility and compliance with the provisions of the Certificate of Coverage. • Process claims to ensure timely and accurate response to claimants. • Generate concisely written correspondence to members, insureds and providers. • Monitor and review pended claims to ensure final determination and follow-up. • Support the Member Benefits Service Department with customer inquiries. • Perform other miscellaneous functions and special projects as assigned.

🎯 Requirements

• High school degree or equivalent. • One year claims analysis and/or claims adjudication experience with Life claims processing preferred. • Knowledge of CPT codes, RVS codes and ICD9/10 coding and medical terminology preferred. • Basic proficiency in MS Office. • Strong attention to detail. • Strong alpha numeric and ten-key typing skills. • Ability to work in a fast paced and changing environment. • Excellent customer service skills. • Good verbal, written and interpersonal skills. • Good deductive reasoning, problem solving and analysis skills.

🏖️ Benefits

• AGIA offers health benefits including medical, dental, and vision. • 401K with 100% company match up to 3% of your annual income and an additional 50% match on the next 2% of income. • A prefunded optional FSA. • 100% covered Life Insurance. • Accidental Death and Dismemberment Insurance. • Short Term/Long Term Disability. • A $250 Wellness Benefit. • 10 days of vacation your first year, and each year you gain an additional day. • 13 paid and closed holidays each year.