to a career that matters
Physicians Mutual is hiring for a full time Senior Claim Examiner in our Claims Department. The selected candidate will evaluate and respond to claim service requests for customers, medical providers and entitled parties. Analyzes all claim information received in conjunction with contestable and incontestable Long Term Care. Other product knowledge, such as Disability, would be helpful.
The Senior Claim Examiner resolves claims in accordance with claim procedures, policy provisions and limitations, policy applications, underwriting guidelines, medical conditions, Company philosophy and state insurance laws. The candidate will correspond with the insured, doctors, hospitals, and other third parties to collect data. In addition, the Senior Claim Examiner will process payment or explain rejection decisions to customers through appropriate communication channels.
Approximately 5 years of increasingly responsible auditing experience in Long Term Care, Disability, or Health Insurance required.
Excellent written and verbal communication skills.
Knowledge of medical conditions and relationship between etiology, symptoms and complicated and related health care procedures.
Process sophisticated problem solving, decision making, and organizational skills.
Ability to function effectively in a production environment.
Associate Degree and/or industry coursework is helpful for this position.
Apply today at physiciansmutual.com/careers
For recruiting purposes only.
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