Accenture Insurance Claims Examiner in San Antonio, Texas
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The Voluntary Benefits Claims Examiner Analyst will support a large Group Insurance Business contract is responsible for the calculation of Voluntary Benefits according to Plan Provisions. This position requires the knowledge and understanding of Voluntary Benefits policies and procedures to appropriately calculate the benefits due. You will be expected to follow through timely on plans, utilize judgment, and assess risk when rendering claim decisions. Able to communicate with various constituents with limited guidance and learn and transact using the client s systems. Expected to communicate clearly concisely to influence return to work, discuss terms of the certificate, and the basis of payment nonpayment.
Document all claim information including phone calls and correspondence
Utilize effective communication to obtain information both verbally and in writing and provide information to the claimant and employer
Ability to apply plan provisions understand the needs of the clients
Expected to adhere to client Service Level Agreements and department s product s key performance requirements and any reporting
Able to utilize strong organizational skills to manage multiple priorities while working under tight time constraints, possess the ability to work through ambiguity, and work effectively with various vendors with strong interpersonal skills
Willing to support special internal functional projects and ad hoc requests as required.
Able to work cohesively with Subject Matter experts to support the day to day tasks, able to anticipate, identify, and resolve complex issues problems.
Able to communicate risks issues to supervisor and help with the resolution, as needed
Provide exceptional customer service either over the phone or through email
Able to provide leadership updates progress reports on training curriculum
Utilize tools independently and accurately to identify work to be completed
Minimum of 1 year experience in Insurance Claims Processing
Minimum of 2 years experience in a contact center/call center
Group Life/Disability Claims experience
Bachelor s Degree
NY Adjustor License
Proficiency in Windows environment, including Word and Excel
Strong mathematical skills
Strong written and verbal communications required
Detailed oriented with strong time management skills
Work hour flexibility 7 am to 7 pm CST
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