Medical Claim Analyst

Company : Crawford

Job Type : Full Time

Remote / Work from Home

Job Description - Medical Claim Analyst

Description

NOW HIRING: War Hazard Coordinator – Defense Base Act (DBA) | 100% Remote

Looking for a career where your work makes a real difference? Join us as a War Hazard Coordinator – Defense Base Act (DBA) and support employees serving on critical defense and government contracts worldwide.

In this dynamic remote role, you'll manage DBA and War Hazards claims, collaborate with global stakeholders, ensure compliance, and help deliver timely support to personnel working in challenging environments. If you're detail-oriented, thrive in a fast-paced setting, and enjoy solving complex problems, this opportunity is for you!

Ready to take your career to the next level while working from anywhere? Apply today and become part of a team that's making a difference around the world!

Responsibilities

Processes "M" Case claims (medical only) within area of payment authority up to, but not exceeding $3,500.
Processes claims, other than “M” cases, have been settled and the claim is only open for recovery.
Contacts, by telephone, insureds, claimants, and medical providers for additional information or medical verifications to verify and report the status of claims.
May verify coverage on claims by following normal coverage confirmation procedures, as requested. Alerts Team Manager of any errors or discrepancies.
Reviews and updates data into a computerized system.
Approves payments of medical bills on lost time disability claims, within payment authority, after compensability has been determined by the Team Manager or claim technician/handler.
Answers routine questions, orally and in writing, from agents, or other interested parties.
Keeps Team Manager informed verbally and in writing of activities and problems within assigned area of responsibility; refers matters beyond limits of authority and expertise to Team Manager for direction.
Consults with other departments and business units.
Documents receipt and contents of medical reports. Reviews and handles other correspondence within authority including material from the team member and customer.
Processes claims, other than “M” cases, where all medical issues have been settled and the claim is only open for recovery.
With the team managers guidance, provides input on the completion of recovery.
Performs other related duties as required or requested.
Upholds the Crawford Code of Business Conduct at all times.
Participates in special projects or performs duties in other areas as requested.
Upholds the Crawford Code of Conduct

Qualifications

College degree or the equivalent education and experience
Two or more years of experience as a Claim Clerk or the equivalent, demonstrating a thorough knowledge of computer entry and operations.
Demonstrates a thorough working knowledge of claim processing and claim policies and procedures.
Demonstrates an understanding of basic medical terminology and appropriate medical tests for claimed conditions
Demonstrates effective and diplomatic oral and written communication skills.
Demonstrates a customer-focused approach including the ability to identify and understand customer needs, and interacts effectively with others

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Medical Claim Analyst

Job Description - Medical Claim Analyst

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