NHS Human Services, Inc.

This position is responsible for reviewing and determining all claim requirements needed for initial and continuation claims. This position assists Care Managers and Care Coordinators, while also providing quality customer service to our policy holders, their representatives and providers. RESPONSIBILITIES 1. Reviews internal databases, client guidelines, and policy contract language to determine all claim requirements needed for initial and continuation claims. 2. Reviews documented claim forms and contacts the insured, insured's representative, or provider to request information needed to process the benefit inquiry. 3. Keeps clear and concise documentation of all claim intake activity within the required databases. 4. Meets quality and production metrics as established and communicated by the department. 5. Processes requests from the client or from other departmental areas within illumifin. 6. Other duties as assigned. Minimum Qualifications * Associates Degree or equivalent formal training program, or 2 years experience in the health or life insurance industry. * 1- 3 years work experience in a claims environment preferred. * Intermediate level experience with Microsoft Office products. Preferred Qualifications * Experience working in a geriatric healthcare environment. * Knowledge of health, long-term care or disability insurance * Excellent verbal and written communication skills. Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled