Equitable Holdings
Claims Intake Specialist (Group Insurance Claims Experience Required)
Equitable Holdings, Charlotte, North Carolina, United States, 28245
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Equitable is seeking a dynamic Claim Intake Specialist to join our Disability and Absence Claims organization. The
Claim Intake Specialist
is responsible for supporting the disability claims process by performing administrative and simple financial tasks, ensuring accuracy, and ensure smooth operations in the claims department. This role involves reviewing claim files, validating information, and supporting the claims team as required.
The ideal candidate will have strong organizational skills, attention to detail, and the ability to work independently in a fast-paced environment. Key Job Responsibilities
Claim Documentation Review: Review and verify the claims documentation, including medical records, claim forms, and supporting paperwork are aligned with the applicable and appropriate claim. Ensure completeness of documentation before it is forwarded for claims adjudication. Coordinate with healthcare providers and claimants to obtain missing or additional information necessary to process claims. Research and resolve issues related to claims, such as discrepancies or missing information, by contacting claimants, medical providers, or other relevant parties as requested by claims specialist. Data Entry & System Management: Input claim information accurately into the claims management system, ensuring all details are captured for proper claims processing. Maintain accurate and up-to-date claim records, including claim status, medical documentation, and payment history. Track the progress of claims and ensure timely updates are made in the system. Claims Verification & Validation: Assess the completeness of the claim files against policy requirements. Ensure claim materials are managed in compliance with company guidelines, insurance regulations, and state/federal laws. Validate medical certifications and supporting documentation to ensure the information provided meets the requirements of the original request. Compliance & Confidentiality: Ensure compliance with all relevant laws, policies, and regulations concerning disability claims and sensitive personal information. Adhere to confidentiality protocols and maintain the privacy of claimant information. Stay informed about changes to disability insurance laws, regulations, and industry best practices. Administrative & Reporting Support: Provide administrative support with documents as required by the claims department. Assist with the generation of monthly or quarterly claims reports, tracking metrics, and performance data. Perform additional administrative duties, such as creating claim copies, requesting additional information such as medical records, reviewing claims files, validating information, filing and organizing claim records and supporting claims team as needed. Other duties as requested Performance & Quality Assurance: Meet or exceed service targets, including call resolution times, customer satisfaction scores, and other key performance indicators (KPIs). Participate in training and professional development programs to improve skills and knowledge. Meet or exceed performance metrics such as call resolution times, customer satisfaction scores, and adherence to schedules. Achieve and maintain required metrics and goals Work and partner with others within a team-based environment The base salary range for this position is $41,000 - $55,115. Actual base salaries vary based on skills, experience, and geographical location. In addition to base pay, Equitable provides compensation to reward performance with base salary increases, spot bonuses, and short-term incentive compensation opportunities. Eligibility for these programs depends on level and functional area of responsibility.
For eligible employees, Equitable provides a full range of benefits. This includes medical, dental, vision, a 401(k) plan, and paid time off. For detailed descriptions of these benefits, please reference the link below. Equitable Pay and Benefits : Equitable Total Rewards Program
Claim Intake Specialist
is responsible for supporting the disability claims process by performing administrative and simple financial tasks, ensuring accuracy, and ensure smooth operations in the claims department. This role involves reviewing claim files, validating information, and supporting the claims team as required.
The ideal candidate will have strong organizational skills, attention to detail, and the ability to work independently in a fast-paced environment. Key Job Responsibilities
Claim Documentation Review: Review and verify the claims documentation, including medical records, claim forms, and supporting paperwork are aligned with the applicable and appropriate claim. Ensure completeness of documentation before it is forwarded for claims adjudication. Coordinate with healthcare providers and claimants to obtain missing or additional information necessary to process claims. Research and resolve issues related to claims, such as discrepancies or missing information, by contacting claimants, medical providers, or other relevant parties as requested by claims specialist. Data Entry & System Management: Input claim information accurately into the claims management system, ensuring all details are captured for proper claims processing. Maintain accurate and up-to-date claim records, including claim status, medical documentation, and payment history. Track the progress of claims and ensure timely updates are made in the system. Claims Verification & Validation: Assess the completeness of the claim files against policy requirements. Ensure claim materials are managed in compliance with company guidelines, insurance regulations, and state/federal laws. Validate medical certifications and supporting documentation to ensure the information provided meets the requirements of the original request. Compliance & Confidentiality: Ensure compliance with all relevant laws, policies, and regulations concerning disability claims and sensitive personal information. Adhere to confidentiality protocols and maintain the privacy of claimant information. Stay informed about changes to disability insurance laws, regulations, and industry best practices. Administrative & Reporting Support: Provide administrative support with documents as required by the claims department. Assist with the generation of monthly or quarterly claims reports, tracking metrics, and performance data. Perform additional administrative duties, such as creating claim copies, requesting additional information such as medical records, reviewing claims files, validating information, filing and organizing claim records and supporting claims team as needed. Other duties as requested Performance & Quality Assurance: Meet or exceed service targets, including call resolution times, customer satisfaction scores, and other key performance indicators (KPIs). Participate in training and professional development programs to improve skills and knowledge. Meet or exceed performance metrics such as call resolution times, customer satisfaction scores, and adherence to schedules. Achieve and maintain required metrics and goals Work and partner with others within a team-based environment The base salary range for this position is $41,000 - $55,115. Actual base salaries vary based on skills, experience, and geographical location. In addition to base pay, Equitable provides compensation to reward performance with base salary increases, spot bonuses, and short-term incentive compensation opportunities. Eligibility for these programs depends on level and functional area of responsibility.
For eligible employees, Equitable provides a full range of benefits. This includes medical, dental, vision, a 401(k) plan, and paid time off. For detailed descriptions of these benefits, please reference the link below. Equitable Pay and Benefits : Equitable Total Rewards Program