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18

February

Senior Assistant Claims Examiner (51000766)

DXC Technology - Melbourne, VIC

Any Industry
Source: uWorkin

JOB DESCRIPTION

Job Description

Essential Job Functions

  • Enters insurance claims received electronically or in written form.
  • Answers incoming customer calls regarding claim processing. Documents claim and associated history.
  • Evaluates available information to validate claims. Verifies policyholder information, policy effective dates, premium status and verification of claim eligibility.
  • Sends claim form to claimant for updating, correction or completion.
  • Investigates simple to moderately complex claims and determines level or resolution if appropriate; advises claimant of status; assists in negotiating settlement and resolution of claim.
  • Identifies need for additional information; contacts appropriate source to obtain needed information. Verifies beneficiary or claimant information if claim is warranted. Identifies payment amount and obtains required management approvals for payment. Processes payment.

Basic Qualifications
  • High school diploma or G.E.D.
  • Fellowship of Life Health Claims (FLHC) Certification preferred
  • Two or more years of auditing, accounting, contracts or information technology experience
  • Experience working with insurance and/or medical terminology
  • Experience working with appropriate claims processing procedures and documentation

Other Qualifications
  • Good analytical and problem solving skills
  • Good interpersonal skills to interact with team members
  • Good communication skills to communicate with clients
  • Good data entry skills
  • Negotiation skills to interact with claimant
  • Ability to keep sensitive and confidential material private
  • Ability to work in a team environment
Work Environment
  • Office environment

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