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Assured Benefits Administrators · 4 months ago

Claims Coordinator

Miami Hybrid, Miami, FL, US

Full-time

Hybrid

New Grad, Entry Level

Assured Benefits Administrators is a prominent company in the health insurance sector, known for its commitment to providing premier medical insurance products. The Claims Coordinator role involves handling inquiries and concerns related to claims, ensuring accurate information is provided to customers while collaborating with various departments to resolve issues effectively.

ConsultingHealth CareManagement Consulting

Responsibilities

Receive and handle customer inquiries from potential, current, and former members, brokers, and providers

Provide timely, accurate, and clear information in response to customer requests

Process customer requests following established departmental policies and procedures

Conduct research and investigations to resolve customer inquiries effectively

Collaborate closely with claims adjudicators and other departments to gather necessary information

Deliver timely feedback to customers through outbound calls, emails, mail, or fax

Identify potential fraudulent claims and take appropriate action in line with company protocols

Assist with client office visits as needed

Report service failures, systemic issues, and customer concerns promptly to the Claims Director or Claims Manager

Generate reports for brokers to facilitate the completion of claims and payment processes

Support the completion of special projects as assigned

Attend and actively participate in meetings and training sessions as required

Perform other duties as assigned

Qualification

Bilingual (English/Spanish)Communication skillsAttention to confidentialityTime managementCustomer serviceSelf-motivationDetail-orientedTeam collaboration