Claims Specialist - LHB
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At Luminare Health , our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job SummaryUnder minimal supervision, the Claims Specialist is responsible for reviewing and investigating high dollar claims and claim appeals to determine if the incurred services were billed, adjudicated, and reimbursed in accordance with the terms and conditions of the applicable client's summary plan document to understand benefit coverage levels. Consistently researches and analyzes claims for accuracy and recommends immediate and long term solutions for improvement.LIFE & DISABILITY - CLAIMS SPECIALIST Secure and analyze claim information to make and approve decisions and payments on life and/or disability claims. Develop, apply and approve appropriate claim and management strategies to ensure prompt and accurate payment and liability management of life and/or disability claims, including complex, high liability or more problematic claims. Provide responsive and caring customer service to internal and external customers; participate actively and effectively in team/department projects and issues. All aspects of claim management completed under minimal supervision of the senior manager. Required Job Qualifications:
Preferred Job Qualifications:
Required Job Qualifications:
Preferred Job Qualifications:
This is a Telecommute (Remote) role. Candidates must live within the following states: IL, IN, IA, KS, MO, MT, NM, NC, OK, PA, TN, TX or WI #LI-PD1 #LI-REMOTE INJLF Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! EEO Statement:We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Pay Transparency Statement: At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan,pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package forassociates. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan. Min to Max Range: $41,400.00 - $77,700.00 |