Health Claims Adjuster

ABOUT INSURANCE ADMINISTRATIVE SOLUTIONS
Insurance Administrative Solutions (IAS) is a third-party provider of comprehensive administrative solutions for our clients in the insurance industry. We offer a business process outsourcing solution that helps insurers optimize administrative workload, bolster their industry expertise, leverage emerging technologies, and streamline operations. With strong industry knowledge, we deliver value to our customers by providing compassionate customer service, efficient processing, and quality results. Here at IAS, we embrace the fact that great things are only accomplished by working as a team. We believe that all of our employees have valuable input no matter the level. Our highly collaborative team environment offers each of our employees a place where they can excel.

Location: Rome, Georgia

JOB SUMMARY: Analyze claims to determine the extent of insurance carrier liability. Interpret contract benefits in accordance with specific claims processing guidelines. Receive, organize and make daily use of information regarding benefits, contract coverages, and policy decisions. Coordinate daily workflow to coincide with check cycle days to meet all service guarantees. Clear understanding of how various functions within the operation relate to and impact each other.

Medical Terminology - Health/Insurance - Supplemental Health Insurance Experience - Fast Pace Environment - AWD Experience - Ability to Read and Interpret EOBs

ESSENTIAL DUTIES & RESPONSIBILITIES (other duties may be assigned as necessary):

• Examine/perform/research & make decisions necessary to properly adjudicate claims and written inquiries.
• Interpret contract benefits in accordance with specific claim processing guidelines.
• Understand broad strategic concept of our business and link these to the day-to-day business functions of claims processing.
• Minimal external contact with providers/agents/policyholders.

EDUCATION/EXPERIENCE:

Associate's degree (AA) or equivalent from two year college or technical school; or six months to one year related experience and/or training; or equivalent combination of education and experience. PC/Windows experience needed.

Benefits:

• Medical/Dental/Vision Benefits first of the month after hire date
• 401(k) Company matching and contributions are immediately vested
• 15 days PTO after 90 days
• Referral program
• 11 Paid Holidays
• Employee Assistance Program
• Tuition Reimbursement

Schedule:

• Monday to Friday
• 37 hour work week

IAS is an equal opportunity employer.