Join Our Team as a Claims Review Specialist at Amwins Self-Funded, LLC! Are you ready to make a meaningful impact in the dynamic world of insurance? , as a Claims Review Specialist.

This is an in-office position, that offers the flexibility to work from home up to 2 days a week after completing training. Why Choose Amwins?

Benefits

to enhance your work experience: Flexibility: Enjoy a hybrid work environment with flexible scheduling options.

: Access a competitive

package from day one, including generous Paid Time Off (PTO) and paid holidays. Continual Learning: Thrive in a collaborative, education-focused work environment. Annual Bonus Program: Earn incentives through our performance-based bonus program, designed to reward you for achieving key goals and contributing to the company's success.

Responsibilities

: Learn Stealth’s Business Model : Understand Amwins Self-Funded business model and the products we support under the guidance of the Claims Manager and Lead Claims Auditor. Effective Correspondence : Correspond accurately and timely with carriers, administrators, clients, and brokers using approved form letters and emails, with all correspondence copied to the Claims Lead. Claim Reports Management : Manage monthly claim reports for the administration of the assigned book of business, ensuring forwarding to the appropriate carrier and following up on missing reports.

Reimbursement Request Review : Review submitted reimbursement requests for completeness and request any missing information. Eligibility Documentation Approval : Obtain approval from the Claims Lead on eligibility documentation noting time-off exceeding twelve (12) weeks before submitting a claim reimbursement request. Claim Submission and Tracking : Record and submit reimbursement requests to the appropriate carrier within authorized dollar authority, tracking and following up on outstanding payments.

Reimbursement Issuance : Review and issue reimbursements, notifying designated contacts accurately and in a timely manner. Claim Tracking Logs : Maintain internal claim tracking logs to ensure accurate records. Year-End Account Closure : Manage the settlement of all reimbursement requests at the end of the plan year to properly close the client’s account.

Adaptability and Team Collaboration : Handle other duties and projects as assigned, showcasing adaptability and strong collaboration skills.

, or physical

Qualifications

Education and Experience : A college degree or equivalent work experience is strongly preferred. Tech Proficiency : Proficiency with Microsoft Office products (Word, Excel, Outlook, and Teams) is preferred. Critical Thinking : The ability to critically think and problem-solve.

Confidentiality : Ability to maintain strict confidentiality. Organizational Skills : Ability to multitask, adjust to changing priorities, and effectively manage time to meet deadlines. Communication Skills : Effective written and verbal communication skills with both internal and external parties.

Attention to Detail and Urgency : A sense of urgency and attention to detail are necessities. Eager to Learn : Eagerness to learn Stealth’s business model is a necessity.

Requirements

for the performance of this job.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.