Description:
We are seeking a dedicated and detail-oriented Claims Associate to manage a diverse portfolio of leave pay and disability claims. As a Claims Associate, you will be responsible for administering disability and leave pay claims for multiple clients, adhering to client policies and plan guidelines. You will ensure claims are processed accurately and efficiently while maintaining high standards of customer service and documentation.
Job Title: Claims Associate
Reports To: Operations Manager
FLSA Status: Non-Exempt
Learn about Gold Standard service delivery while focusing primarily on claim success.
Job Duties and Essential Functions
- Administer a full workload of disability and/or leave pay claims for multiple (8+) clients per client policies and plan guidelines. Claims administration includes, but is not limited to:
- Confirming plan eligibility and whether a claim is payable;
- Reviewing medical documentation and communicating with healthcare providers;
- Opening/approving/extending/closing claims;
- Drafting letters to be sent to employees regarding disability benefits, including denial letters;
- Calculating reductions;
- Maintaining high-quality employee disability claim files according to set standards and naming conventions; and
- Providing 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 the accurate coordination between client leave compensation pay and other income replacement benefits.
- Weekly self-audits; claim status reports sent to manager with explanation of any outliers.
- Able to take on additional work with short notice (e.g. client needs to be taken over on short notice due to business needs).
- When required, coordinate between short-term disability insurance carriers, worker's compensation insurance providers, and the employee.
- Participate in client meetings, company-wide off-site meetings, and training programs which may require some infrequent travel.
- Available to back up multiple accounts.
- Perform other duties as assigned in order to meet business needs.
- Expected to work 40 hours per week.
- Expected to report to the office five days per week; at six months of tenure, the ability to work a hybrid schedule including at least two days in the office per week is assessed based on performance. Hybrid work schedules are subject to change depending on performance and business needs.
- Perform above duties in the office between regular business hours: Monday to Friday, 8am to 5pm (PST)
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. Experience with insurance companies or in the insurance industry is a plus.
- Proficient typing and strong knowledge of MS Excel and MS Word.
- Always focused on providing excellent customer service.
- Ability to prioritize tasks and focus on the most important ones.
- Ability to communicate effectively with colleagues, leadership, clients, and employees.
- Have a system for keeping track of work to ensure that the work is done on time and accurately.
- Ability to identify and solve problems quickly and efficiently.
- Willing to learn and take on new challenges.
- Takes the initiative to understand the why behind things.
- Receptive to feedback and embraces continuous improvement.
- Planning ahead, managing time well, being on time, and thinking of better ways to do things.
- Being helpful, respectful, approachable and team-oriented, building strong working relationships and contributing to a positive work environment.
- Excellent follow through and common sense.
- Excellent attention to detail.
- Strong organizational, quantitative, and verbal/written communications skills.
- Ability to comprehend a variety of informational documents including, but not limited to, disability plan documents and client leave policies.
- Ability to comprehend and interpret a variety of reference books and manuals including administrative manual, personnel policies, and state and federal regulations.
- Ability to keep abreast of any changes in law, policy, methods, procedures, etc. as they pertain to clients.
To learn more about The Larkin Company, our culture, and the generous benefits we offer, check out our company website:
The above job description is meant to describe 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 The Larkin Company, we are committed to creating 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: 0 Yearly Salary
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