Claims Processing Associate

Amwins

Posted 3 months ago

Full Time

Bluffton, Indiana

Hybrid

Smart Summary

Responsibilities

The associate manages claim reports, reviews reimbursement requests, and coordinates with carriers and brokers to ensure accurate payment tracking. They are also responsible for maintaining internal logs and managing year-end account closures for clients.

Qualifications

You have a college degree or equivalent work experience, coupled with proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams). You are expected to demonstrate strong organizational skills, attention to detail, and effective communication abilities to manage claim processing tasks and maintain confidentiality.

Must Have Skills for ATS

Microsoft Office

Excel

Outlook

Teams

Word

Job Description

Join Our Team as a Claims Processing Associate at Amwins Self-Funded, LLC!   Are you ready to make a meaningful impact in the dynamic world of insurance? Join Awmins Self Funded, LLC., as a Claims Processing Processor. This is an in-office position in Bluffton, IN that offers the flexibility to work from home up to 2 days a week after completing training.   Why Choose Amwins? At Amwins, we value our team members and offer a range of benefits to enhance your work experience:
  • Flexibility: Enjoy a hybrid work environment with flexible scheduling options.
  • Comprehensive Benefits: Access a competitive benefits package from day one, including generous Paid Time Off (PTO) and paid holidays.
  • Continual Learning: Thrive in a collaborative, education-focused work environment.
  • Annual Bonus Program: Earn incentives through our performance-based bonus program, designed to reward you for achieving key goals and contributing to the company's success.
Learn more about us at amwins.com/benefits.   Responsibilities:   As a Claims Processing Associate, you will:
  • Learn Stealth’s Business Model: Understand Amwins business model and the products we support under the guidance of the Claims Manager and Lead Claims Auditor.
  • Effective Correspondence: Correspond accurately and timely with carriers, administrators, clients, and brokers using approved form letters and emails, with all correspondence copied to the Claims Lead.
  • Claim Reports Management: Manage monthly claim reports for the administration of the assigned book of business, ensuring forwarding to the appropriate carrier and following up on missing reports.
  • Reimbursement Request Review: Review submitted reimbursement requests for completeness and request any missing information.
  • Eligibility Documentation Approval: Obtain approval from the Claims Lead on eligibility documentation noting time-off exceeding twelve (12) weeks before submitting a claim reimbursement request.
  • Claim Submission and Tracking: Record and submit reimbursement requests to the appropriate carrier within authorized dollar authority, tracking and following up on outstanding payments.
  • Reimbursement Issuance: Review and issue reimbursements, notifying designated contacts accurately and in a timely manner.
  • Claim Tracking Logs: Maintain internal claim tracking logs to ensure accurate records.
  • Year-End Account Closure: Manage the settlement of all reimbursement requests at the end of the plan year to properly close the client’s account.
  • Adaptability and Team Collaboration: Handle other duties and projects as assigned, showcasing adaptability and strong collaboration skills.
  Qualifications: To excel in this role, you'll need:
  • Education and Experience: A college degree or equivalent work experience is strongly preferred.
  • Tech Proficiency: Proficiency with Microsoft Office products (Word, Excel, Outlook, and Teams) is preferred.
  • Critical Thinking: The ability to critically think and problem-solve.
  • Confidentiality: Ability to maintain strict confidentiality.
  • Organizational Skills: Ability to multitask, adjust to changing priorities, and effectively manage time to meet deadlines.
  • Communication Skills: Effective written and verbal communication skills with both internal and external parties.
  • Attention to Detail and Urgency: A sense of urgency and attention to detail are necessities.
  • Eager to Learn: Eagerness to learn Stealth’s business model is a necessity.
    The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities, or physical requirements. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  

Amwins

At Amwins Benefits, we’ve created a portfolio of capabilities that span the benefits landscape, and we deliver them with hands-on service and expertise you can trust. So, whether you need a partner for the day-to-day or a problem solver for the complex, our goal is that whenever you think of benefits, you think of us. Whether it's small to mid-market, self-funded, ancillary, exclusive programs, or retiree healthcare, you can count on us for a fully integrated experience, in-depth regional expertise, customized retailer marketing strategies and white-glove sales support.
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