Morgan White Group · 3 hours ago
Claims Analyst
Miami, FL
Full-time
Onsite
Entry Level
1+ years expMorgan White Group is seeking a Claims Analyst to join their MWG-International Division. The role involves processing and adjudicating claims, communicating with clients and agents, and investigating medical information necessary for claim determinations.
Financial ServicesHealth CareInsurance
Hiring Manager
Naomi Suarez
Responsibilities
Processing and adjudication
Analyzing the claims to properly adjudicate it according to the policy benefits and limitations
Responsible for all emails and phone calls with clients and agents regarding the assigned cases
Responsible for investigating any medical information needed to properly process a claim by requesting medical records or any other document needed to providers and/or insureds (USA, Latin American and/or the Caribbean) to make a determination on the claim submitted
Responsible for writing and submitting letters of denial to insureds, letters of exclusionary riders or cancellation of coverage to the Insured when necessary
Prepare medical evaluations for cases on excess of $100.000.00 or on any cases in which a retroactive exclusionary rider needs to be applied
Communicate to Insured on a formal letter of any Lloyd’s decision regarding an appeal of a claim
Qualification
Required
Requires high school diploma or general education degree or equivalent or 1 year of related experience
Medical knowledge to be able to analyze a medical claim submitted to determine eligibility
Communication skills – verbal, written and listening skills
Knowledge of Microsoft outlook, excel and word
Each employee must pass a drug screen
Reports must be received from criminal background investigation and review of work references
Must be capable of maintaining regular attendance
Must be capable of performing the essential job functions of the position, with or without reasonable accommodations
BILINGUAL REQUIRED: Must be able to read, write, and speak English and Spanish
Must have basic typing skills
Must be able to work as scheduled
Must possess sight and hearing senses or use prosthetics that will enable these senses to function adequately so that the requirements of the position as stated above can be fully met
Must be able to bend, stretch, reach, and sit or stand at a desk during 85% of the workday
Must be able to lift, stoop, and carry small equipment items and supplies, possibly weighing up to 20lbs
Must be able to perform in a very high paced environment and professionally handle interruptions
Must have the ability to work under minimal supervision
Must be able to prioritize projects, work multiple projects simultaneously, and meet project deadlines
Must possess excellent problem-solving skills and have keen attention to details
Must demonstrate strong written and verbal communication, interpersonal, and relationship building skills
Must be able to handle stressful situations appropriately
Must maintain confidentiality and privacy in every aspect of the job
Company
Morgan White Group
Morgan White Group is an insurance company offering brokerage services, dental, and vision insurance products.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
David R. White, RHU
Chief Executive Officer
Ryan Eaton
Executive Vice President, Chief Marketing Officer
Company data provided by crunchbase