Agent managing specialized health insurance claims for Beneva, an insurance and financial services company. Analyzing medical evidence, communicating decisions, serving policyholders, and processing payments.
Responsibilities
Review, process, and analyze health insurance benefit claims for specialized products
Analyze information contained in assigned files, taking into account contractual provisions, medical and/or death-related evidence, government programs, and internal policies and procedures
Communicate decisions or recommendations primarily in writing regarding benefit approval, requests for additional information, or claim denials
Provide customer service to insured individuals, policyholders, and/or beneficiaries
Obtain specific information, communicate claim-related information, and respond to calls
Perform technical tasks to support the management of assigned files
Use relevant computer systems to update data and process payments in accordance with contracts and internal guidelines
Requirements
Hold a college diploma (DEC) in a relevant field
Advanced proficiency in French, both spoken and written
Advanced proficiency in English, both spoken and written
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