Health and Disability Claims Examiner at CEI Group

Health and Disability Claims Examiner

Full Job Description:
The role reports directly to the Supervisor Claim Support. The role is responsible for providing timely support to the Claim Services Department while demonstrating the highest levels of service professionalism in all they do.

MUST HAVE: Direct Life Claims experience. 

The role is expected to:

• Prepare items for imaging, including new claims, correspondence, closed claim files, and notification of claims.
• Provide back up to data imager.
• Index relevant items for pending and closed claims.
• Sort all Claims Services mail.
• Pull claim files associated with incoming mail and deliver to Examiners for handling.
• Scan correspondence, medical records and other claim forms and correspondence.
• Photocopy pertinent items such as death certificates, envelopes, claim forms.
• Provide statistical reporting of mail and pending mail.
• Research returned mail.
• Set up new claims as needed.
• Distribute claim kits as requested
• Handle routine status Customer Service Calls, document calls and refer complex call to the Examiners.
• Mail claim checks.
• Retrieve, review, and distribute faxes and emails received via the claim department inbox.
• Typing of letters as requested.
• Look ups on MASS.DOR/CSLN/LEXIS NEXIS.
• Other duties and special projects as required.