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SalaryCLAIM ELIGIBILITY SPECIALIST
Continental General Insurance Company - Austin, TX 78717
Looking to join a growing company dedicated to helping others? We offer that, plus competitive salaries, great culture, and a relaxed environment. This position allows for a fully remote or hybrid work environment which consists of 2 days per week in the office and 3 days per week remote, if desired. Join our team to help make a difference in the lives of others.
About Continental General
The Continental Insurance family of companies has provided Long Term Care Insurance to individuals and groups for over 30 years and currently provides Long Term Care coverage to approximately 55,000 lives. Continental Insurance, Inc. is primarily focused on managing the Long Term Care Insurance portfolio of its insurance company subsidiaries and pursuing opportunities to expand its Long Term Care Insurance portfolio through acquisitions and strategic partnerships.
The Position:
Investigates and maintains simple complexity claims, including but not limited to:
Reviews and evaluates coverage and / or liability.
Analyzes necessary information (i.e., reports, policies, appraisals, releases, statements, records, or other documents) to determine eligibility claim decisions.
Establishes appropriate Plan of Care according to Claim Handling Guidelines
Accurately documents claim record with eligibility details.
Conveys simple claim details (coverage, decisions, expectations, etc.) to all appropriate parties, maintaining a professional demeanor in all situations.
Ensures claims handling is conducted in compliance with applicable statues, regulations, and other legal requirements, and that all applicable company procedures and policies are followed.
Performs other duties as assigned.
Note: Applicants must be authorized to work for a U.S. employer without sponsorship. We are unable to sponsor or take over sponsorship of an Employment Visa at this time or at any time in the future.
Education: High School Diploma or equivalent
Experience: 6 months to 3 years of related experience
Scope of Job:
Works within specific limits and authority on assignments of moderate complexity.
Handles claims of high frequency and low severity
Possesses basic functional knowledge and skills reflective of study and / or on the job development.
Possesses good verbal and written communication skills.
Performs work under moderate supervision.
