Job Description

Position: Claims Adjuster

Location: Fairfax, VA #Remote

Duration: Contract to Hire

Job Description :

• Investigate and perform adjustment of claims and ensure that claims are handled properly within authority limits, and in line with standard procedures and guidelines.
• Verifies insurance claims by reviewing claims requirements; examining documentation and calculations; highlighting and summarizing out-of-line situations; recommending changes in operating processes; completing reports, logs, and audit records.
• Education Level: High School Diploma or GED
• 5+ years claims experience and complete understanding of all systems, policies and procedures.
• Experience with Inter-Plan Teleprocessing System (ITS) Claims.
• Ability to analyze information gathered from investigation, Proficient
• Excellent communication skills both written and verbal., Proficient
• Ability to recognize, analyze, and solve a variety of problems., Proficient
• Skill in completing assignments accurately with attention to detail., Proficient

Required Skills :

• Verbal Communication Skills
• Adobe Acrobat
• MS Excel, Outlook
• Problem Solving Skills
• Time Management

ESSENTIAL FUNCTIONS :

• 60% Proactively investigate and perform adjustments of claims. Ensure claims are handled within authority limits, and in line with standard procedures and guidelines.
• 20% Updates claims audit records by entering, verifying, and securing data.
• 10% Settle standard/complex claims through payment or denial.
• 5% Provides claims audit information and reports by collecting, analyzing, and summarizing data and trends.
• 5% Improves claims adjustment job knowledge by attending training sessions

Thanks & Regards,
--

LAXMAN
Team Lead - Talent Acquisition

KMM Technologies, Inc.

CMMI Level 2 | ISO 9001 | ISO 20000 | ISO 27000 Certified

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