Physicians Mutual Insurance Company

Physicians Mutual’ s Claims department is seeking full time Claims Examiner. The selected candidate will be analyzing health claim forms, medical records and provider bills to decide eligibility to pay benefits, request additional information, or deny claims. Strong customer service skills are required to be to be successful in this role. This role includes frequent phone contact with our customers, and free form written communication.

ABOUT THE JOB

Qualifications: High school diploma or equivalent. Two years of college is preferred. 1-2 years of previous health insurance, med supp or related experience preferred. Must demonstrate strong verbal communication skills. Ability to read policy contracts. Ability to handle complex claim situations. Ability to operate a PC and all applicable programs and applications. Must possess problem solving, decision-making, and organizational skills. Ability to function effectively in a production environment with high quality work. Ability to learn quickly and adapt to new insurance coverages, procedures and guidelines. Basic math needed to calculate benefits and interest. About us: Health. Life. Retirement. The Physicians Mutual family empowers people from all walks of life to enjoy the financial security they deserve. That’s what Insurance for all of us® is about. The Physicians Mutual family includes Physicians Mutual Insurance Company and Physicians Life Insurance Company. Physicians Mutual Insurance Company offers reliable dental and supplemental health insurance (and now, pet insurance!). Physicians Life Insurance Company provides important Medicare Supplement and life insurance coverage. The company additionally offers coverage for funeral pre-planning to help meet the growing needs of funeral home owners and the families they serve. Since our start in 1902, our dedication to delivering on our promise has helped make us one of the nation’s leading health and life insurance providers. In fact, we are rated in the top 1% of insurance companies. We consistently maintain some of the highest financial strength ratings in the nation from independent insurance analysts, including A.M. Best Company and Weiss Ratings, ensuring we’ll be there for our policyowners and our employees far into the future. But the achievement we’re most proud of? We have a 95% customer approval rating — a true sign of a company dedicated to embodying its vision.

RESPONSIBILITIES

• Analyzing health claim forms, medical records, and provider bills to decide eligibility to pay benefits.
• Request additional information or deny claims as necessary.
• Maintain frequent phone contact with customers.
• Engage in free form written communication with stakeholders.

QUALIFICATIONS

• High school diploma or equivalent.
• Two years of college is preferred.
• 1-2 years of previous health insurance, med supp or related experience preferred.
• Strong verbal communication skills.
• Ability to read policy contracts.
• Ability to handle complex claim situations.
• Ability to operate a PC and all applicable programs and applications.
• Problem solving, decision-making, and organizational skills.
• Ability to function effectively in a production environment with high quality work.
• Ability to learn quickly and adapt to new insurance coverages, procedures, and guidelines.
• Basic math skills needed to calculate benefits and interest.

BENEFITS

• Financial security
• Coverage for funeral pre-planning

OTHER

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