Claims Support Specialist (Remote)

{"description": " Claims Support Specialist (Remote)

Department: Claims Administration & Adjusting

Employment Type: Permanent - Full Time

Location: Home United States

Reporting To: Mary McFaul

Compensation: $18.20 - $21.15 / hour

Description

Our Story

Imagine being part of a team that's not just shaping the future but actively driving it. At Davies North America , we're at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.

What's in Store
We are on the lookout for an experienced Claims Support Specialist who will provide administrative support for Davies Life & Health (DLH) Lloyds block of business in the processing and management of insurance claims. You will be responsible for managing client data and reports, verifying information for new claim submissions, maintaining claim systems, and assisting in the preparation and review of client reports.

In addition, you be assisting with the administration of medical reimbursement claims, and will also provide support for claim adjusters and managers in the claim evaluation process by preparing form packets, gathering and verifying proof of loss documentation, handling client communication, and ensuring accurate records in compliance with company procedures and regulatory requirements.

Key Responsibilities

Claim and Client Data Management

• Verify and manage client data in IDEAS (claim administration system)
• Set up and manage claim billing in TSheets, including changes, accounting notices, and split bill notifications for multiple clients
• Complete funding allocation spreadsheets and manage off-cycle invoice processing
• Assist with preparation of Bordereaux (BDX) reports containing both claim and financial data
• Conduct sanctions checks for international claims
• Run weekly, monthly, and quarterly IDEAS reports for management review
• Manage client data distribution lists and support ad hoc/periodic client report requests
• Maintain complaint logs for client reporting

Claim Support

• Prepare and send initial claim forms packets and notifications emails to clients
• Assist in administration of major medical, student accident, and/or long-term duration disability claims
• Enter monthly expenses for investigative and medical records fees approved by claim adjusters
• Gather and review proof of loss
• Assess benefit eligibility and process benefit payments
• Manage client communications/claim report updates as needed
• Provide timely and thorough communication to clients and insureds
• Support ongoing handling of disability with long-term or repetitive pay duration
• Process eligible benefits
• Obtain, review, and verify periodic proof of loss
• Maintain client communications and claim report updates

This role is a full-time remote position.

Skills, knowledge & expertise

• High school diploma/GED with some claim-related or industry experience (e.g., long-term care, disability insurance) preferred, or equivalent combination of education and experience
• Experience with medical reimbursements for accidents
• Excellent communication skills
• Strong attention to detail and organizational skills
• Self-motivated with the ability to work independently and take initiative
• Strong follow-through and ability to manage processes holistically
• Proficiency in Excel (i.e. formulas, filters, and data comparisons)

Equal Employment Opportunity & Legal Notices

Benefits

At Davies North America, we are dedicated to supporting the well-being and future of our qualifying employees. Our comprehensive benefits package includes:

• Medical, dental, and vision plans to support your health and that of your family
• A 401(k) plan with employer matching
• Time-off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non-exempt employees
• Paid holidays
• Life insurance and short-term and long-term disability coverage

Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee's primary work location.

Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements.

Diversity and Inclusion

Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard.

Compensation Transparency:
The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.

Background Check & Fair Chance Compliance

Any background check or review of criminal history, if applicable to the role, will be conducted only after a conditional offer of employment and in compliance with applicable federal, state, and local laws, including fair-chance hiring requirements.

Massachusetts Notice It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at [email protected]", "salary_raw": "Row(double=None, string='USD 18.20 - 21.15 per hour')"}