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Role Description

ManhattanLife is seeking a Claims Specialist for our office located in De Pere, WI. This role directly supports our organization’s Claims team. Claims Specialists evaluate medical claims submissions and process the claims on our systems. Our Claims Specialists also provide customer service to our policyholders over the phone. This position has the option to be remote.

Duties and Responsibilities

• Evaluate claims based on documentation received and provide timely follow-ups for claims being adjudicated.
• Process insurance claims with adherence to company policies and contract provisions in full accordance with the law.
• Make decisions and ensure the successful resolution of inquiries and complaints by preparing accurate and timely activity reports.
• Communicate via written correspondence or e-mail to claimants.

Qualifications

• High School Graduate or equivalent (GED).
• 1-3 years of claims experience preferred.
• Solid knowledge of ICD-9, ICD-10 or medical coding.
• Excellent phone skills and an ability to communicate in a friendly and effective manner with our customers.
• Background in insurance claims is preferred in any discipline of Medicare Supplement, Life, Health, Cancer or Disability.
• Ability to read and understand policy language.
• Understanding of basic medical terminology.
• Ability to work independently and in a team environment.
• Ability to prioritize and manage workload to meet deadlines.

Travel Requirements

• This position does not require travel.

Professional Development

• Establish annual objectives for professional growth.
• Keep pace with developments in the discipline.
• Learn and apply technologies that support professional and personal growth.
• Participate in the evaluation process.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee is regularly required to:

• Stand; walk; use hands to finger, handle or feel objects, type, and use mouse;
• Reach with hands and arms and talk and/or hear;
• Sit for extended periods of time;
• Lifting, pulling or moving items weighing upwards of 10 pounds as it relates to office or desk supplies.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee regularly works in an office environment. This role routinely uses standard office equipment such as:

• Computers;
• Phones via WebEx;
• Physical phone while in office;
• Photocopiers when necessary.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to the job at any time without notice.

AAP/EEO Statement

ManhattanLife prohibits discrimination based on race, religion, gender, national origin, age, disability, veteran status, marital status, pregnancy, gender expression or identity, sexual orientation, or any other legally protected status. EOE Employer/Vet/Disabled. ManhattanLife values differences. We are committed to fostering an environment that attracts and retains a diverse workforce. With individuals from a variety of backgrounds, ManhattanLife will be better equipped to service our customers, increase innovation, and reduce risks. We encourage the unique perspectives of individuals and are dedicated to creating a respectful and inclusive work environment.