Department	Benefits
Category	Benefits
City	Oklahoma City
State	OK
Travel Involved	0-10%
Type of Position	Full-Time

Remote & Hybrid DI Adjuster II

AFA / CERS

Description:

*Remote (must live 150 miles outside of OKC area)

*Hybrid (live in OKC area within 150 miles)

*Evaluates, processes and/or audits claims that require moderate to complex judgement and investigation such as Accident, Critical Illness, Hospital Indemnity, HRA, FSA Claim Adjustments, Stop Loss, New Short Term Disability or Medlink claims in accordance with Company policy terms, insurance laws, regulatory requirements and adjusting guidelines.

*Provides appropriate verbal and/or written communication to internal and external Customers in a positive and knowledgeable manner to ensure a high standard of Customer service. Meets standards established in department performance metrics for appropriate handling of Customer phone calls.

*Acts as a direct contact and communicates with internal and external Customers and medical providers in a positive, knowledgeable and professional manner, providing them with direction and assistance in all facets of insurance coverage and needs.

Requirements:

Prompt and reliable
Good understanding of medical terminology and physiology
Possesses PC Windows-based software knowledge, including intermediate proficiency in Microsoft Office applications, with the ability to train on new applications and work in a paperless environment
Knowledge of insurance claims processes and regulations, preferred
Knowledge of case management tools and ability to apply
Good analytical skills
Good communication skills, both verbal and written
Good interpersonal skills (team orientation)
Ability to multi-task in a fast paced environment
Ability to be flexible in work schedule, including a willingness to work overtime as needed
Good judgment skills
Organizational skills
Professional attitude
Dedicated to providing world-class Customer service
Ability to work well within a team environment
- REMOTE ONLY: required 1 to 2 years disability claims experience

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