Morgan Stephens represents the nation’s top healthcare systems offering the highest compensation and benefits to our top candidates. We are created and managed by experienced industry professionals in healthcare. As a leading provider of contract, contract to perm, and direct placement recruiting services to healthcare organizations throughout the United States, we have successfully served the needs of our employees and clients by placing thousands of quality healthcare professionals into organizations seeking top talent.
We are seeking a Medical Claims Representative. A Medical Claims Representative develops skills and acquires knowledge necessary to investigate and resolve personal lines casualty claims via telephone or face to face investigation or negotiation. Responsible for the handling of claims in accordance with prescribed authority and according to claims best practices. Promotes and provides great customer service. Develops skills and acquires knowledge necessary to investigate and resolve personal lines casualty claims via telephone or face to face investigation or negotiation. Responsible for handling of claims in accordance with prescribed authority and best claims practices.
Prepare files for reassignment as needed.
Authorizes and/or approves all claims payments within the delegated authority or within the maximum limits as outlined in company policies and procedures.
Determines proper policy coverages, and where necessary, investigates, evaluates, negotiates and equitable settles all assigned casualty claims cases in accordance with company guidelines. Learns to utilize best claims practices.
Establishes and authorizes reserves and claims payments within the delegated authority. Recommends for approval all claims payments beyond delegated authority in accordance with company practices and procedures.
Submits administrative reports as required.
Initiates and conducts follow-ups via proficient use of the claims handling system or other related systems.
Other duties as assigned.