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Claims Associate

2 months ago

Roseville, California, United States Larkin Benefit Administrators Full time
Job Summary

We are seeking a highly skilled and detail-oriented Claims Associate to join our team at Larkin Benefit Administrators. As a Claims Associate, you will be responsible for managing a diverse portfolio of leave pay and disability claims for multiple clients, ensuring accurate and efficient processing while maintaining high standards of customer service and documentation.

Key Responsibilities
  • Administer a full workload of disability and/or leave pay claims for multiple clients, adhering to client policies and plan guidelines.
  • Confirm plan eligibility and whether a claim is payable, reviewing medical documentation and communicating with healthcare providers.
  • Open, approve, extend, or close claims, drafting letters to be sent to employees regarding disability benefits, including denial letters.
  • Calculate reductions, maintain high-quality employee disability claim files according to set standards and naming conventions, and provide excellent customer service by processing payments in a thorough and timely manner.
  • Collaborate with Employee Success team members by answering questions regarding pay eligibility, documentation required, client policies, and benefits.
  • Communicate regularly with Employee Success team members, Team Leads, employees, and client contacts to ensure accurate coordination between client leave compensation pay and other income replacement benefits.
  • Perform weekly self-audits and claim status reports sent to manager with explanation of any outliers.
  • Be able to take on additional work with short notice, coordinate between short-term disability insurance carriers, worker's compensation insurance providers, and the employee, and participate in client meetings, company-wide off-site meetings, and training programs.
  • Available to back up multiple accounts and perform other duties as assigned to meet business needs.
Requirements
  • A Bachelor's degree in Business Administration, Human Resources, Healthcare Administration, Finance, Accounting, or a related field is required.
  • Minimum of 1 year of relevant financial-processing work experience in claims administration, human resources, healthcare administration, or finance/accounting, with experience with insurance companies or in the insurance industry being a plus.
  • Proficient typing and strong knowledge of MS Excel and MS Word.
  • Excellent customer service skills, ability to prioritize tasks, and focus on the most important ones.
  • Ability to communicate effectively with colleagues, leadership, clients, and employees, and have a system for keeping track of work to ensure it is done on time and accurately.
  • Ability to identify and solve problems quickly and efficiently, willing to learn and take on new challenges, and receptive to feedback and continuous improvement.
  • Strong organizational, quantitative, and verbal/written communications skills, ability to comprehend a variety of informational documents, and ability to keep abreast of any changes in law, policy, methods, procedures, etc. as they pertain to clients.