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Claims Intake Specialist (Insurance Claims Experience Required)
Equitable
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See open jobs at Equitable.See open jobs similar to "Claims Intake Specialist (Insurance Claims Experience Required)" This is CNY.Administration
Syracuse, NY, USA
USD 41k-55,115 / year
Posted 6+ months ago
Claims Intake Specialist (25000053)
Primary Location
: UNITED STATES-NC-CharlotteOther Locations
: UNITED STATES-Remote, UNITED STATES-NY-SyracuseOrganization
: EquitableSchedule
: Full-timeDescription
At Equitable, our power is in our people.
We're individuals from different cultures and backgrounds. Those differences make us stronger as a team and a force for good in our communities. Here, you'll work with dynamic individuals, build your skills, and unleash new ways of working and thinking. Are you ready to join an organization that will help unlock your potential?
Equitable is seeking a dynamic Claim Intake Specialist to join our Disability and Absence Claims organization. The Claim Intake Specialist is responsible for supporting the disability claims process by performing administrative and simple financial tasks, ensuring accuracy, and ensure smooth operations in the claims department. This role involves reviewing claim files, validating information, and supporting the claims team as required. The ideal candidate will have strong organizational skills, attention to detail, and the ability to work independently in a fast-paced environment.
Key Job Responsibilities
Claim Documentation Review:
- Review and verify the claims documentation, including medical records, claim forms, and supporting paperwork are aligned with the applicable and appropriate claim.
- Ensure completeness of documentation before it is forwarded for claims adjudication.
- Coordinate with healthcare providers and claimants to obtain missing or additional information necessary to process claims.
- Research and resolve issues related to claims, such as discrepancies or missing information, by contacting claimants, medical providers, or other relevant parties as requested by claims specialist.
Data Entry & System Management:
- Input claim information accurately into the claims management system, ensuring all details are captured for proper claims processing.
- Maintain accurate and up-to-date claim records, including claim status, medical documentation, and payment history.
- Track the progress of claims and ensure timely updates are made in the system.
Claims Verification & Validation:
- Assess the completeness of the claim files against policy requirements.
- Ensure claim materials are managed in compliance with company guidelines, insurance regulations, and state/federal laws.
- Validate medical certifications and supporting documentation to ensure the information provided meets the requirements of the original request.
Compliance & Confidentiality:
- Ensure compliance with all relevant laws, policies, and regulations concerning disability claims and sensitive personal information.
- Adhere to confidentiality protocols and maintain the privacy of claimant information.
- Stay informed about changes to disability insurance laws, regulations, and industry best practices.
Administrative & Reporting Support:
- Provide administrative support with documents as required by the claims department.
- Assist with the generation of monthly or quarterly claims reports, tracking metrics, and performance data.
- Perform additional administrative duties, such as creating claim copies, requesting additional information such as medical records, reviewing claims files, validating information, filing and organizing claim records and supporting claims team as needed.
- Other duties as requested
Performance & Quality Assurance:
- Meet or exceed service targets, including call resolution times, customer satisfaction scores, and other key performance indicators (KPIs).
- Participate in training and professional development programs to improve skills and knowledge.
- Meet or exceed performance metrics such as call resolution times, customer satisfaction scores, and adherence to schedules.
- Achieve and maintain required metrics and goals
- Work and partner with others within a team-based environment
The base salary range for this position is $41,000 - $55,115. Actual base salaries vary based on skills, experience, and geographical location. In addition to base pay, Equitable provides compensation to reward performance with base salary increases, spot bonuses, and short-term incentive compensation opportunities. Eligibility for these programs depends on level and functional area of responsibility.
For eligible employees, Equitable provides a full range of benefits. This includes medical, dental, vision, a 401(k) plan, and paid time off. For detailed descriptions of these benefits, please reference the link below.
Equitable Pay and Benefits: Equitable Total Rewards Program
Qualifications
Required Qualifications
- Graduate in any stream
- Understanding of medical terminology, coding (ICD-10, CPT), and insurance policies
- Proficiency with Microsoft Office Suite (Word, Excel, Outlook) and claims management software.
- Ability to work independently and manage multiple claims simultaneously.
- Knowledge of medical terminology and insurance terms is helpful.
- Ability to maintain confidentiality and manage sensitive information with discretion.
- Ability to adapt to changing procedures and workflows in a dynamic environment.
Preferred Qualifications
- Previous experience in an insurance claims back-office role, preferably within disability, life or voluntary benefits is required. ,
- Strong understanding of disability insurance processes, claims management systems, and regulatory requirements is a plus.
Skills
Effective Communications: Understanding of effective communication concepts, tools and techniques; ability to effectively transmit, receive, and accurately interpret ideas, information, and needs through the application of appropriate communication behaviors.
Managing Multiple Priorities: Knowledge of effective self-management practices; ability to manage multiple concurrent objectives, projects, groups, or activities, making effective judgments as to prioritizing and time allocation.
Project Administration: Knowledge of project administration best practices and ability to use organizational strategies, practices and tools for administering projects.
Diversity, Equity and Inclusion: Demonstrates a commitment to Diversity, Equity and Inclusion by treating everyone with respect and dignity, ensuring all voices are heard and advocating for change.
ABOUT EQUITABLE
At Equitable, we’re a team of over ten thousand strong; committed to helping our clients secure their financial well-being so that they can pursue long and fulfilling lives.
We turn challenges into opportunities by thinking, working, and leading differently – where everyone is a leader. We encourage every employee to leverage their unique talents to become a force for good at Equitable and in their local communities.
We are continuously investing in our people by offering growth, internal mobility, comprehensive compensation and benefits to support overall well-being, flexibility, and a culture of collaboration and teamwork.
We are looking for talented, dedicated, purposeful people who want to make an impact. Join Equitable and pursue a career with purpose.
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Equitable is committed to providing equal employment opportunities to our employees, applicants and candidates based on individual qualifications, without regard to race, color, religion, gender, gender identity and expression, age, national origin, mental or physical disabilities, sexual orientation, veteran status, genetic information or any other class protected by federal, state and local laws.
NOTE: Equitable participates in the E-Verify program.
If reasonable accommodation is needed to participate in the job application or interview process or to perform the essential job functions of this position, please contact Human Resources at (212) 314-2211 or email us at TalentAcquisition@equitable.com.
This job is no longer accepting applications
See open jobs at Equitable.See open jobs similar to "Claims Intake Specialist (Insurance Claims Experience Required)" This is CNY.