Claims Specialist

Fort Washington, Pennsylvania

Job ID: #84976

MOUNTAIN, LTD. has an opening for a Claims Specialist in the Fort Washington, PA area.

Since 1979, MOUNTAIN, LTD. has successfully created and supported the most innovative career pathways for job seekers. Our dedicated internal vendor management has a longstanding relationship across diverse industries, ranging from telecom to insurance. In the evolving landscape of employment, MOUNTAIN has relationships with some of the top companies across the nation.

 Job Responsibilities:

  • Analyze routine insurance claims to determine the extent of the insurance carrier's liability and to settle claims in accordance with the plan provisions.
  • Sets adequate reserves to ensure proper reporting.
  • Compares data on claim form with insurance plan to ascertain completeness and validity of claim.
  • Examines claim form and other records to determine insurance coverage.
  • Proactively works to resolve claim as expeditiously as possible.
  • Reviews and analyze detailed medical records.
  • Calculates reimbursement of benefits according to the schedule of coverage.
  • Runs various claim reports as directed by the account.
  • Approves claims at the appropriately demonstrated assigned authority level. Handles difficult phone calls.
  • Composes special correspondence.
  • Works on special projects and tasks as assigned.
  • Other duties as assigned.

 

Requirements:

  • Claims adjudication experience or relevant Berkely experience.
  • Writes clearly, concisely and effectively.
  • Communicates verbally effectively and with impact.
  • Computer literate.
  • Detail oriented.
  • Ability to multi-task Manages time effectively.
  • Committed to superior customer servicing.
  • Ability to work independently, a self- starter.

 

Thank you for your interest in MOUNTAIN, LTD. For more information please contact mdiemedio@mountainltd.com.

Format: XXX-XXX-XXXX
Include a message to the recruiters.
Attach a resume file. Accepted file types are DOC, DOCX, PDF, HTML, and TXT.

Equal Opportunity

System One is an Equal Opportunity Employer. As required by law, we must record certain information to be made a part of our Affirmative Action Program. We are also asking you to tell us if you have or ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.


Applicants for employment are also invited to participate in the Affirmative Action Program by reporting their status. In extending this invitation you are also advised that: (a) workers (applicants) are under no obligation to respond, but may do so in the future if they choose; (b) responses will remain confidential within the Human Resources Department; and (c) responses will be used only for the necessary information to include in our Affirmative Action Program. We are a company that values diversity. We actively encourage women and minorities to apply. Refusal to provide this information will have no bearing on your application and will not subject you to any adverse treatment.


By clicking Submit Application below, you certify that all representations, responses and statements made by you in connection with your application for employment are true, complete and correct to the best of your knowledge and belief. You understand that any falsification, misrepresentation or omission of information will be sufficient cause for rejecting your application, eliminating you from further consideration for employment, withdrawal of any employment offer, or termination of employment, should you be hired.

We are uploading your application. It may take a few moments to read your resume. Please wait!