Claims PL Casualty Medical Representative (remote)

If you're excited about this role but don’t meet every qualification, we still encourage you to apply! At Grange, we value growth and are committed to supporting continuous learning and skill development as you advance in your career with us.

Summary : This position is responsible for investigating, evaluating and negotiating settlement of assigned Medical Payments claims with the goal of serving the customer and ensuring quality file handling.

What You'll Be Doing :

• Pursuant to Company line of business strategies and good faith claim settlement practices : investigates, evaluates, negotiates and settles (within authorized limits) assigned Medical Payment coverage claims.
• Establishes and maintains positive relationships with both internal and external customers providing excellent customer service.
• Review and analysis of medical claims including, but not limited to, the analysis and interpretation of medical records and reports.
• Reviews medical bills for accuracy and reasonableness, utilizing independent discretion, bill review software and established best practices.

What You’ll Bring To The Company :

High school diploma or equivalent education and experience required plus three years related experience preferred. Bachelor's degree in related field preferred. Must possess strong communication and organization skills and ability to work with personal computer. Must be able to work both independently and within a team environment using sound judgment in decision-making. Able to work well under deadlines in a changing environment and perform multiple tasks effectively and concurrently. Demonstrated ability to interact with people in a professional manner, determine coverage, investigate and determine liability needed. State specific adjusters’ license may be required.