*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.