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Claims Processing Specialist

2 months ago

Atlanta, Georgia, United States Larkin Benefit Administrators Full time

We are looking for a meticulous and committed Claims Associate to oversee a varied portfolio of leave compensation and disability claims. In this role, you will be tasked with managing disability and leave pay claims for various clients, ensuring compliance with client policies and plan specifications. Your focus will be on processing claims accurately and efficiently while upholding exceptional standards of customer service and documentation.

Position Title: Claims Associate

Reports To: Operations Manager

FLSA Status: Non-Exempt

Embrace Gold Standard service delivery while prioritizing claim success.

Key Responsibilities

  • Manage a comprehensive workload of disability and/or leave pay claims for numerous clients (8+) in accordance with client policies and plan specifications. Claims management encompasses, but is not limited to:
  • Verifying plan eligibility and determining claim payability;
  • Assessing medical documentation and liaising with healthcare providers;
  • Initiating/approving/extending/closing claims;
  • Composing correspondence to employees regarding disability benefits, including denial notifications;
  • Calculating benefit reductions;
  • Maintaining high-quality employee disability claim files in line with established standards and naming conventions;
  • Delivering outstanding customer service by processing payments thoroughly and promptly.
  • Collaborate with Employee Success team members by addressing inquiries related to pay eligibility, required documentation, client policies, and benefits.
  • Engage in regular communication with Employee Success team members, Team Leads, employees, and client contacts to ensure precise coordination between client leave compensation pay and other income replacement benefits.
  • Conduct weekly self-audits; submit claim status reports to the manager with explanations for any discrepancies.
  • Be prepared to take on additional responsibilities with short notice (e.g., managing a client transition due to business needs).
  • When necessary, coordinate between short-term disability insurance carriers, workers' compensation insurance providers, and employees.
  • Participate in client meetings, company-wide off-site gatherings, and training sessions which may require occasional travel.
  • Be available to support multiple accounts.
  • Perform other duties as assigned to meet business needs.
  • Expected to work 40 hours per week.
  • Expected to report to the office five days per week; after six months of employment, the opportunity for a hybrid schedule including at least two days in the office per week will be evaluated based on performance. Hybrid work schedules are subject to change based on performance and business requirements.
  • Execute the above duties in the office during regular business hours: Monday to Friday, 8am to 5pm (EST)

Qualifications:

  • A Bachelor's degree in Business Administration, Human Resources, Healthcare Administration, Finance, Accounting, or a related field is required.
  • At least 1 year of relevant financial-processing experience in claims administration, human resources, healthcare administration, or finance/accounting. Experience with insurance companies or within the insurance sector is advantageous.
  • Proficient typing skills and strong knowledge of MS Excel and MS Word.
  • Consistently focused on delivering excellent customer service.
  • Ability to prioritize tasks effectively and concentrate on the most critical ones.
  • Strong communication skills to interact effectively with colleagues, leadership, clients, and employees.
  • Possess a system for tracking work to ensure timely and accurate completion.
  • Ability to identify and resolve issues swiftly and efficiently.
  • Willingness to learn and embrace new challenges.
  • Proactive in understanding the rationale behind processes.
  • Open to feedback and committed to continuous improvement.
  • Demonstrated ability to plan ahead, manage time effectively, and innovate processes.
  • Exhibit helpfulness, respectfulness, approachability, and teamwork, fostering strong working relationships and contributing to a positive work environment.
  • Exceptional follow-through and common sense.
  • Outstanding attention to detail.
  • Strong organizational, quantitative, and verbal/written communication skills.
  • Ability to comprehend a variety of informational documents, including disability plan documents and client leave policies.
  • Ability to interpret various reference materials, including administrative manuals, personnel policies, and state and federal regulations.
  • Ability to stay informed about changes in laws, policies, methods, and procedures as they relate to clients.

To learn more about Larkin Benefit Administrators, our culture, and the generous benefits we offer, please visit our company website.

The above job description is intended to outline the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required for the position.

At Larkin Benefit Administrators, we are dedicated to fostering an inclusive and diverse work environment. We are proud to be an equal opportunity employer and do not discriminate against any employee or applicant based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected characteristics. We believe that diverse perspectives and experiences drive innovation and success. All qualified candidates are encouraged to apply.

The salary for this position is determined based on several factors, including relevant skills and experience, industry knowledge, market rates, geographic location, and internal equity. We aim for transparency and fairness in our compensation practices and welcome any questions during the hiring process.



Compensation details: Yearly Salary



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