Job Description:

Processes highly complex claims to ensure accurate and timely processing. Leads and oversees the work of others.

Essential Job Functions

• Conducts correspondence related to client requests for information.
• Evaluates available information to validate claims. Verifies policyholder information, policy effective dates, premium status and verification of claim eligibility.
• Identifies need for additional information; contacts appropriate source to obtain needed information. Verifies beneficiary or claimant information if claim is warranted. Identifies payment amount and obtains required management approvals for payment. Processes payment.
• Investigates highly complex claims and determines level of resolution if appropriate; advises claimant of status; negotiates settlement and resolution of claim.
• Receives demand letters; researches and investigates claims, responds within individual parameters and escalates as appropriate.

Basic Qualifications

• High school diploma or G.E.D.
• Fellowship of Life Health Claims (FLHC) Certification preferred
• Six or more years of insurance/claims processing experience
• Experience working with insurance and/or medical terminology
• Experience working with appropriate claims processing procedures and documentation

Other Qualifications

• Strong analytical and problem solving skills
• Strong interpersonal skills to interact with team members
• Strong communication skills to communicate with clients
• Strong negotiation skills to interact with claimant
• Good human relations skills to provide leadership and work guidance to less experienced personnel
• Ability to keep sensitive and confidential material private
• Ability to work in a team environment

Work Environment

• Office environment

If you are an applicant from the United States, Guam, or Puerto Rico

DXC Technology is an Equal Opportunity/Affirmative Action employer. All qualified candidates will receive consideration for employment without regard to disability, protected veteran status, race, color, religious creed, national origin, citizenship, marital status, sex, sexual orientation/gender identity, age or genetic information. DXC's commitment to diversity and inclusive selection practices includes ensuring qualified long-term unemployed job seekers receive equal consideration for employment. View postings below.

We participate in E-Verify. In addition to the posters already identified, DXC provides access to prospective employees for the Federal Minimum Wage Poster, Federal Polygraph Protection Act Poster as well as any state or locality specific applicant posters. To access the postings in the link below, select your state to view all applicable federal, state and locality postings. Postings are available in English, and in Spanish, where required. View postings below.

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