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CLAIMS ANALYST
at Old National Bank in Indiana
Old National Insurance has an opportunity for a Claims Analyst, Third Party Administration, in its Ft. Wayne office. The purpose of the Third Party Administration department is to provide claims service to those customers sold TPA services by the agency’s employee benefit producers. The Claims Analyst is responsible for examining and submitting claims, determining eligibility of coverage under applicable plans, and processing claims in keeping with set standards.
Job Responsibilities:
Process health claims for groups assigned.
Evaluate the submitted claim forms for completeness and accuracy.
Decision each submitted claim.
Contact policyholder, physician, hospital or other sources when required.
Contact other insurance carrier to facilitate the exchange of information required for processing claims involving Coordination of Benefits.
Complete pre-treatment estimates for medical procedures as necessary.
Determine prevailing fees for medical procedures.
Explain benefit payments, policy provisions, policy interpretations and reasons for declinations of benefits to policy owner when required.
Verify benefit coverage to physicians and hospitals.
Review involved surgeries and determine proper benefits; determine prevailing fee for surgeries and make proper adjustments as necessary; review complaint letters from doctors, insured, etc. concerning policy benefits.
Identify possible subrogation claims and send proper letters.
Identify possible Large Case Management claims.
Qualifications:
2 to 3 years experience processing health claims.
In-depth knowledge of claims adjudication.
10 key proficient.
Strong communication, organizational, and reasoning and math skills.
Ability to work independently.
Strong attention to detail.
Diversity…Our differences enhance business performance
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://oldnationalbancorp.contacthr.com/17186250
Job Responsibilities:
Process health claims for groups assigned.
Evaluate the submitted claim forms for completeness and accuracy.
Decision each submitted claim.
Contact policyholder, physician, hospital or other sources when required.
Contact other insurance carrier to facilitate the exchange of information required for processing claims involving Coordination of Benefits.
Complete pre-treatment estimates for medical procedures as necessary.
Determine prevailing fees for medical procedures.
Explain benefit payments, policy provisions, policy interpretations and reasons for declinations of benefits to policy owner when required.
Verify benefit coverage to physicians and hospitals.
Review involved surgeries and determine proper benefits; determine prevailing fee for surgeries and make proper adjustments as necessary; review complaint letters from doctors, insured, etc. concerning policy benefits.
Identify possible subrogation claims and send proper letters.
Identify possible Large Case Management claims.
Qualifications:
2 to 3 years experience processing health claims.
In-depth knowledge of claims adjudication.
10 key proficient.
Strong communication, organizational, and reasoning and math skills.
Ability to work independently.
Strong attention to detail.
Diversity…Our differences enhance business performance
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://oldnationalbancorp.contacthr.com/17186250
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Published on Sep 20, 2010
Viewed: 249 times
Viewed: 249 times
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