Allstate Benefits - Senior Claims Associate (Supplemental Health) - Jacksonville, FL (Hybrid)

The world isn’t standing still, and neither is Allstate. We’re moving quickly, looking across our businesses and brands and taking bold steps to better serve customers’ evolving needs. That’s why now is an exciting time to join our team. You’ll have opportunities to take risks, challenge the status quo and shape the future for the greater good.

 

You’ll do all this in an environment of excellence and the highest ethical standards – a place where values such as integrity, inclusive diversity and accountability are paramount. We empower every employee to lead, drive change and give back where they work and live. Our people are our greatest strength, and we work as one team in service of our customers and communities.

 

Everything we do at Allstate is driven by a shared purpose: to protect people from life’s uncertainties so they can realize their hopes and dreams. For more than 89 years we’ve thrived by staying a step ahead of whatever’s coming next – to give customers peace of mind no matter what changes they face. We acted with conviction to advocate for seat belts, air bags and graduated driving laws. We help give survivors of domestic violence a voice through financial empowerment. We’ve been an industry leader in pricing sophistication, telematics, digital photo claims and, more recently, device and identity protection.

 

We are the Good Hands. We don’t follow the trends. We set them.

Job Summary:

The Senior Claims Associate is responsible for analyzing and adjudicating supplemental health insurance claims in accordance with policy provisions with minimal guidance from the medical team or leadership team.  A claims examiner must have the ability to interpret and apply laws, rules and regulations as well as evaluate claims from initial report to final determination. They must also be able to obtain and utilize sensitive information discreetly and objectively in addition to documenting claim files with notes, evaluations and decision-making processes while achieving optimal customer service.

Key Responsibilities:

•    A Senior Associate is responsible for analyzing, processing, researching, adjusting and adjudicating claims which will result in a payment or nonpayment of a claim with minimal guidance from the medical team or leadership team. 
•    Senior Associates review insurance policies, the claim form and supporting documentation to make sure that all of the information is correct.  They determine whether the claims are covered under the policies issued to that policyholder.
•    Senior Associates assist in identifying, investigating and reporting fraudulent claim activity to our internal fraud unit.
•    Senior Associates are required to provide the insured with correspondence that is clear, concise and meets state regulations in relation to the decision they made on the claim processed.

Supervisory Responsibilities:

This job does not have supervisory duties.

Knowledge/Skills/Abilities/Experience:

•    High School diploma
•    Ability to work in a fast paced/deadline driven environment. 
•    Ability to work independently or in a team-oriented environment.
•    Ability to interpret and apply laws, rules and regulations.
•    Health insurance claims processing experience and insurance regulation knowledge highly preferred
•    Outstanding verbal (telephone) and written communication skills 
•    Attend training sessions as a participant
•    Moderate individual decision making
•    Basic individual claim authorization, with the ability to use Microsoft Excel and Word tools
•    Ability to prioritize and handle multiple tasks
 

Notes:

Regular, predictable attendance is an essential function of this job.  Flexible work schedules are available. 
 

The preceding description is not designed to be a complete list of all duties and responsibilities. May be required to perform other related duties as assigned. Regular, predictable attendance is an essential function of this job.

Compensation offered for this role is $38,150.00-$66,162.50 per year and is based on experience and qualifications.

The candidate(s) offered this position will be required to submit to a background investigation, which includes a drug screen.

 

Good Hands. Greater Together. ℠

 

As a Fortune 100 company and industry leader, we provide a competitive salary – but that’s just the beginning. Our Total Rewards package also offers benefits like tuition assistance, medical and dental insurance, as well as a robust pension and 401(k). Plus, you’ll have access to a wide variety of programs to help you balance your work and personal life -- including a generous paid time off policy. For a full description of Allstate’s benefits, visit https://www.alls