Sr. Claims Examiner HYBRID

Sr. Claims Examiner HYBRID

Pay rate : $32.59 / hr W2

LOCATION : Olathe, Kansas - (Hybrid, required to be in the office 2-3 days per week)

DURATION : 6 Months (potential for this role to be temp to perm)

The Claims Examiner II Accident and Health will be responsible to handle all aspects of claim resolution for assigned claims while providing world class service to external and internal customers.

Specific accountabilities :

• Confirm coverage of claims (accident and sickness claims, hospital cash claims, out of country medical and business-related travel claims) by reviewing policies and documents submitted in support of claims.
• Analyze coverage and communicate coverage position.
• Conduct, coordinate, and direct investigation into loss facts.
• Determine eligibility of claims and amounts owed under the terms of the contract.
• Recognize and pursue subrogation where warranted.
• Recognize and make appropriate Risk and Fraud referrals.
• Operate within our best practices guidelines, including timely reserve review, notes, payment requests, electronic diary.
• Other duties as assigned.