Claims Adjuster I

Job Summary

Providing claim service remotely, the full-time Claims Adjuster I will evaluate, adjudicate, and process claims in a timely manner while ensuring compliance with state regulations and company policies.

Key responsibilities

• Review policy provisions and medical documentation to make appropriate claim decisions
• Calculate benefit payments and process claims using the appropriate administrative system
• Communicate with beneficiaries and policyholders to request additional documentation and inform them of claim decisions

Required qualifications

• Bachelor's degree preferred or equivalent to 8 years of work-related experience
• 3 years of customer service experience in the insurance or financial services industry, with 1 year of claims experience preferred
• Basic knowledge of claims administrative procedures and insurance products
• Proficiency in Microsoft Word, Excel, and Outlook
• Good critical thinking and decision-making abilities