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Claims Examiner III

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Job Snapshot
Location:
Wilmington, DE 19801 (map it!Map it! )
Employee Type:
Full-Time
Industry:
Insurance
Manages Others:
Not Specified
Job Type:
Insurance
Admin - Clerical
Education:
2 Year Degree
Experience:
Not Specified
Travel:
None
Post Date:
10/30/2009
Contact Information
Ref ID:
PCK333-121859
Description Highlights

Job ID: 50102

Position Type: Full Time - Regular

Location: DE-Wilmington (downtown)

Relocation: No

Requirements:

  • High School diploma
  • 4 years of Medical Claims experience
  • Knowledge of Group claims processing
  • Customer service experience
  • Knowledge of applicable claims systems
  • Knowledge of medical terminology
  • Excellent written and oral communication skills

    Education: Some College

    Experience: 3-5 years

    Description:

  • Investigate contestable/fraudulent claims with duplicate coverage
  • Handle subrogation actions
  • Monitor medical claims procedures in branch offices and worldwide AIG affiliate offices, as appropriate
  • Audit and review complex medical claims
  • Coordinate refunds with NY Accounting Department and Home Office Administration
  • Review policies to determine eligibility of claimant and policy status
  • Apply applicable claims provisions; evaluate claims, process, and adjudicate claims
  • Process reinsurance if applicable
  • Under immediate supervision, learn medical claim examining practices and procedures, including evaluation, investigation, and processing
  • Gather information and documents
  • Code and adjudicate claims online
  • Coordinate benefits between primary and secondary carrier
  • Answer routine inquiries

    This position is located in Wilmington, Delaware. Relocation will be considered on a case by case basis.

    About Us:

    Alico is a leading international life insurer with a unique heritage of serving customers across the globe for over 85 years. The company provides consumers and businesses with products and services for life insurance, accident and health insurance, retirement planning, and wealth management solutions. Through an extensive network of over 40,000 agents, brokers and financial institutions and 11,000 employees across 54 countries, Alico services 19 million customers worldwide.

    Alico has branch offices, subsidiaries and affiliates in emerging, developing and developed markets in Europe, Asia, the Middle East, Africa and Latin America. Alico is domiciled in Wilmington, Delaware and has regional headquarters in Tokyo, Paris, Athens, Dubai, and Santiago, Chile.
    • Requirements .

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