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Careers Mutual Of Omaha logo
Careers Mutual Of Omaha

Applicants for this position must not now, nor at any point in the future, require sponsorship for employment. This role is classified as remote; however, periodic in-person attendance will be required at times for activities such as quarterly or project planning, training, or other business-critical meetings.

Hospital Indemnity Claims Analyst

Location

United States + 1 moreAll locations: United States | Puerto Rico

Posted

94 days ago

Salary

$21 / year

Seniority

Mid Level

No structured requirement data.

Job Description

Hospital Indemnity Claims Analyst

Careers Mutual Of Omaha

Role Description Reviews and evaluates Medicare Supplement claims to ensure accurate, timely, and thorough processing. Analyzes claim information to determine appropriate next steps while ensuring compliance with internal policies and regulatory requirements and delivering a high-quality customer experience. Qualifications - Current working knowledge within Hospital Indemnity and Hospital Indemnity product knowledge. - Current working experience in Hospital Indemnity call center skills. - Current experience within the Hospital Indemnity business area/acumen, with the ability to work independently and collaboratively while maintaining a positive, team-oriented approach. - Strong analytical, organizational, and decision-making skills with close attention to detail. - Excellent communication and customer service skills, with proficiency in common computer systems and the ability to manage complex or escalated situations. - Promotes a culture of diversity and inclusion, values different ideas and opinions, and listens courageously, remaining curious in all that you do. - Able to work remotely with access to a high-speed internet connection and located in the United States or Puerto Rico. Requirements - Evaluate and process complex Medicare Supplement claims by reviewing medical records, contract language, and supporting documentation to determine accurate payment or denial decisions. - Analyze claim information, process transactions, and communicate with internal and external customers to obtain details, resolve inquiries, and finalize claims. - Deliver high-quality customer service across phone, email, and written correspondence while resolving issues and creating clear explanations of claim determinations. - Ensure compliance with company policies, regulatory requirements, and department standards while identifying potential referrals (e.g., legal, underwriting, special investigations). - Contribute to team success through knowledge sharing, training support, process improvement initiatives, and maintaining strong relationships with customers and colleagues. Benefits - Hourly Wage: $21.25, plus annual bonus opportunity. - 401(k) plan with a 2% company contribution and 6% company match. - Work-life balance with vacation, personal time, and paid holidays.

Job Requirements

  • Current working knowledge within Hospital Indemnity and Hospital Indemnity product knowledge.
  • Current working experience in Hospital Indemnity call center skills.
  • Current experience within the Hospital Indemnity business area/acumen, with the ability to work independently and collaboratively while maintaining a positive, team-oriented approach.
  • Strong analytical, organizational, and decision-making skills with close attention to detail.
  • Excellent communication and customer service skills, with proficiency in common computer systems and the ability to manage complex or escalated situations.
  • Promotes a culture of diversity and inclusion, values different ideas and opinions, and listens courageously, remaining curious in all that you do.
  • Able to work remotely with access to a high-speed internet connection and located in the United States or Puerto Rico.
  • Evaluate and process complex Medicare Supplement claims by reviewing medical records, contract language, and supporting documentation to determine accurate payment or denial decisions.
  • Analyze claim information, process transactions, and communicate with internal and external customers to obtain details, resolve inquiries, and finalize claims.
  • Deliver high-quality customer service across phone, email, and written correspondence while resolving issues and creating clear explanations of claim determinations.
  • Ensure compliance with company policies, regulatory requirements, and department standards while identifying potential referrals (e.g., legal, underwriting, special investigations).
  • Contribute to team success through knowledge sharing, training support, process improvement initiatives, and maintaining strong relationships with customers and colleagues.

Benefits

  • Hourly Wage: $21.25, plus annual bonus opportunity.
  • 401(k) plan with a 2% company contribution and 6% company match.
  • Work-life balance with vacation, personal time, and paid holidays.

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Claims Specialist - Crop

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QBE, a global insurance leader, is the proud parent company of NAU Country Insurance Company. NAU Country writes in 48 states and has nine locations nationwide. Together, we combine the history, expertise, innovation, and a shared commitment to excellence to provide unparalleled insurance solutions to our customers and communities worldwide.

OtherRemoteTeam 10,001

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Job Closed
QBE Insurance Group logo

Senior Claims Specialist

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OtherRemoteTeam 10,001

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QBE Insurance Group logo

Claims Specialist - Crop

QBE Insurance Group

QBE, a global insurance leader, is the proud parent company of NAU Country Insurance Company. NAU Country writes in 48 states and has nine locations nationwide. Together, we combine the history, expertise, innovation, and a shared commitment to excellence to provide unparalleled insurance solutions to our customers and communities worldwide.

OtherRemoteTeam 10,001

Primary Details Time Type: Full time Worker Type: Employee Claims Specialist – Crop The Opportunity: In this role you will deliver prompt and accurate claims service to policyholders and agents for both multi-peril crop insurance (MPCI) and crop hail claims by completing field inspections, communicating with involved parties, performing investigations, determining appropriate adjustments and administering insurance policies to ensure compliance with state and federal regulations. 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Ensure compliant and cost effective application of crop policies by leveraging knowledge of insurance statues and regulations and complying with state and federal regulatory requirements •Provide effective and timely communication with agencies in defined territory on claim status and other inquiries •Build and maintain relationships with customers by providing timely an accurate policy service, answering questions and communicating adjustment determinations •Coach claims adjusting team by supporting and mentoring team members and providing advice and feedback to guide the success of the team and meet service level expectations •Provide information and feedback regarding the quality of agent business and/or policy files of regional claim operations to maximize profit and quality of business •Deliver classroom and field training programs for claims technology applications and crop programs ensuring effective educational resources for clients and alignment of training services with key stakeholders expectations •Participate with internal committee to develop global claims technology solutions that support business need •Attend National Crop Insurance Services (NCIS) regional and state committee meetings to make business aware of any legal issues or changes that will impact the business •Contribute to a positive work environment by demonstrating cultural expectations and influencing others to reward performance and value “can do” people, accountability, diversity and inclusion, flexibility, continuous improvement, collaboration, creativity and fun Required Education •Associate's Degree or equivalent combination of education and work experience Required Experience •4 years relevant experience Required Licenses/Certifications •Crop Adjuster Proficiency Program (CAPP); must possess a valid Driver’s License Preferred Competencies/Skills •Evaluate project outcomes through analyzing current state and desired future state •Utilize effective communication channels for both external and internal customers •Handle complex claims using a logical approach •Provide adjusters detailed instructions for claim procedures and company policy •Support implementation of company strategies •High attention to detail •Solve day-to-day problems, using critical thinking •Train others on process and procedures Preferred Experience •5 years experience in MPCI and Crop Hail claims experience Preferred Knowledge •Working knowledge of claims administration best practices and procedures •Understanding of local, state and industry standards (NCIS) •Understanding of relevant laws and regulations across multiple jurisdictions •Working knowledge of Microsoft Office suite, general computer software and database systems QBE, a global insurance leader, is the proud parent company of NAU Country Insurance Company. NAU Country writes in 48 states and has nine locations nationwide. Together, we combine the history, expertise, innovation, and a shared commitment to excellence to provide unparalleled insurance solutions to our customers and communities worldwide. Compensation Package: The salary range for this role is provided above. This is the national range for location(s) listed. The salary offer will be decided based on the role's complexity, its location, and the candidate’s professional background, including their education and experience. Beyond the base salary, regular full-time and part-time employees will also be eligible for QBE’s annual discretionary bonus plan based on business and individual performance. We encourage all candidates to apply, even if their salary expectations fall outside of this range, as we are committed to finding the right fit for our team. QBE Benefits: We offer a range of benefits to help provide holistic support for your work life, whatever your circumstances. As a QBE employee you will have access to: - Hybrid Working – a mix of working from home and in the office - 22 weeks of paid leave for family growth, with 12 weeks available to all parents on a gender-equal basis - Competitive 401(k) program with company match up to 8% - Well-being program including holistic wellbeing coaching, gym membership, confidential counselling, financial and legal advice - Tuition Reimbursement for professional certifications, and continuing education - Employee Network and Community – QBE actively supports six Employee Networks, and many ways to give back to your community To learn more, click here: Benefits | QBE US. Why QBE? What if you could have a positive impact – at work and in the world? At QBE, we’re enabling a more resilient future – for our customers, communities, environment, and for our people. We’re building momentum to achieve something significant and know our people are at the center of our success. Our industry offers interesting and varied careers where you can help people to protect what matters most. As part of the QBE team, you’ll get to spend every day working with people who are passionate, talented and kind. And our international scale means we’re big enough for your ambitions, yet small enough for you to make a real impact. Join us now, so you can be part of our success – and we can be part of yours! https://www.linkedin.com/company/qbe-north-america/ Commitment to Diversity QBE is committed to providing reasonable accommodation to, among others, individuals with disabilities and disabled veterans. If you need an accommodation because of a disability to search and apply for a career opportunity with QBE, please inform our Talent Acquisition team to let us know the nature of your accommodation request and your contact information. Equal Employment Opportunity: QBE provides equal employment opportunities to applicants and employees without regard to race; color; gender; gender identity; sexual orientation; religious practices and observances; national origin; pregnancy, childbirth, or related medical conditions; protected veteran status; or disability or any other legally protected status. Supplementary information Skills: Analytical Thinking, Business Support, Claims Administration, Claims Resolution, Communication, Critical Thinking, Customer Service, Detail-Oriented, Document Management, Financial Management, Intentional collaboration, Managing performance, Risk Management, Sound Judgment, Stakeholder Management How to Apply: To submit your application, click "Apply" and follow the step by step process. Equal Employment Opportunity: QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.

United States
$64K - $96K / year
Job Closed