Premium Waiver Assessor null

Working Arrangement:

Hybrid

Job Description:

The Opportunity

• The customer is the focus of everything we do, and millions of end users rely on our products daily. We believe in the value of empowering our employees with the resources they need to succeed and for the future of our business, which is why we need you.

What motivates you?

• You obsess about customers, listen, engage and act for their benefit

• You think big, with curiosity to discover ways to use your agile mindset and enable business outcomes

• You thrive in teams, and enjoy getting things done together

• You take ownership and build solutions, focusing on what matters

• You do what is right, work with integrity and speak up

• You share your humanity, helping us build a diverse and inclusive work environment for everyone

We are looking for someone with:

• Bachelor’s Degree (4 year program)

• Excellent communication skills, both verbal and written

• Technical competence to navigate through insurance terms and medical references.

• Ability to work independently and/or as a team.

• Critical attention to detail for functions such as entering, verifying and comparing data.

• Excellent ability to handle multiple tasks and prioritize appropriately.

• Excellent understanding of Navigator and other Citrix applications.

• Ability to use Avaya/Amazon telephony system

• HYBRID Work Arrangement – amenability and readiness to work onsite and from home anytime (dependent on business needs AND/OR current external environment/situation).

On the job you will:

• Ensure all documents required are received before processing the claim

• Follow-up with employer regarding missing forms, clarification of information, to confirm if employee has returned to work

• Call members to follow-up with their current and conduct interview to assess members’ activities of daily living

• Send out requests for Attending Physician Updates on a timely manner Send out approval letters and/or decline letters

• Send fax to employer and physician's office to follow-up missing information

• Interpret contractual wordings correctly

• Ensure member has coverage and eligibility prior to waiving of premiums

• Refer claims to Perm unit if necessary

• Provide claim updates to case managers and/or employers when necessary