Claims Specialist - Accident & Health

Job description

Primary Details Time Type: Full time Worker Type: Employee: Job Description: Claims Specialist - Accident and Health Location: USA – MA, Marblehead and GA, Atlanta Work Arrangement: Hybrid: The salary range for this role is: $76,000 - $125,500 The Opportunity: The purpose of this role is to provide exceptional claims service to customers by managing complex medical stop loss claims effectively. This includes assessing policy coverage, investigating, evaluating, and negotiating claims, as well as collaborating with suppliers and stakeholders while offering technical support. Responsibilities: Support the implementation of the Claims strategy to enable the delivery of overall business targets. Maintain current knowledge of insurance guidelines, policy changes, and modifications. Maintain good client relationships with insured individuals, agents, service providers, and the general public. Provide claim management for various types of insurance claims. Identify and implement strategies to minimise Claims Costs and Leakage. Respond to client requests following service standards. Assist with the negotiation of claims settlements. Participate in relevant meetings to share and develop str...