Claims Processor

About Amwins and the Role

Join the Amwins Self-Funded team as a Claims Analyst and be part of a vibrant insurance environment. This position is based onsite in Mesa, AZ, with the opportunity to work remotely up to two days per week after completing initial training.

Reasons to Join Amwins

• Enjoy a flexible hybrid work schedule tailored for work-life balance.
• Access a comprehensive benefits plan including generous paid time off and paid holidays from your first day.
• Engage in a collaborative and education-driven workplace that fosters continual learning.
• Benefit from an annual bonus program that rewards your performance and contribution to company goals.

Key Responsibilities

• Gain a thorough understanding of Amwins' business model and product offerings under the guidance of the Claims Manager and Lead Claims Auditor.
• Communicate promptly and accurately with carriers, administrators, clients, and brokers using pre-approved letters and emails, ensuring the Claims Lead is copied.
• Manage monthly claim report submissions for assigned books of business, confirm report delivery to carriers, and follow up on any missing data.
• Review reimbursement requests to verify completeness and solicit missing details when necessary.
• Seek Claims Lead approval on eligibility documents noting absences exceeding 12 weeks before submitting reimbursement claims.
• Process reimbursement submissions within authorized limits, track payments, and follow up on outstanding amounts.
• Oversee issuance of reimbursements and notify designated contacts accurately and promptly.
• Maintain detailed claim tracking logs for internal record-keeping.
• Handle year-end account closures by settling all reimbursements to ensure proper client account completion.
• Exhibit adaptability by assisting with other assigned projects and collaborating effectively with the team.

Qualifications and Skills

• A college degree or comparable professional experience is highly preferred.
• Familiarity with Microsoft Office suite including Word, Excel, Outlook, and Teams is advantageous.
• Strong critical thinking and problem-solving abilities.
• Maintain confidentiality in all professional duties.
• Effective multitasking capabilities with strong organizational skills to meet shifting priorities and deadlines.
• Excellent verbal and written communication skills with both internal personnel and external partners.
• Attention to detail and a sense of urgency in daily tasks.
• Motivated to learn and understand Amwins’ business processes thoroughly.

This job description summarizes the general requirements and responsibilities of the role and is not exhaustive. Reasonable accommodations are available to qualified individuals with disabilities.