Bill Adjudication Adjuster
- Career Level
- Not Specified
Where good people build rewarding careers.
Think that working in the insurance field cant be exciting, rewarding and challenging? Think again. Youll help us reinvent protection and retirement to improve customers lives. Well help you make an impact with our training and mentoring offerings. Here, youll have the opportunity to expand and apply your skills in ways you never thought possible. And youll have fun doing it. Join a company of individuals with hopes, plans and passions, all using and developing our talents for good, at work and in life.
Allstate Insurance Company has an exceptional career opportunity for a Bill Adjudication Adjuster with a RHIT certification in Farmington Hills, MI.
Think that working in the insurance field cant be exciting, rewarding or challenging? Allstate Insurance has an exciting career opportunity that will utilize your customer service and technical skills to deliver on our promise to provide fast, fair, and efficient claim service. If you have the passion to help others and build the success of a great company, join the Allstate team.
What you will do:
- Deliver exceptional and courteous customer service
- Investigate, evaluate, and negotiate liability claims to ensure a positive customer experience
- Accurately document claim information using Allstates state-of-the-art NextGen claims system
- Work collaboratively with a team in a fast-paced environment
- Achieve targeted performance goals to support Allstates industry leading operation standards
- Assess medical/physical condition and prior injuries of claimant, and obtains and analyzes medical bills, wage loss reviews, home service or attendant care, mileage payments, and other related claims to determine reasonableness of charges and relation of injuries to accident, and to ensure compliance with fee schedules, and detect duplicate billing
- Evaluate medical records and treatment plan of claimant and determine if continued treatment is reasonable
- Determine appropriate benefit and negotiate and settle moderately complex and occasionally complex claims, including resolution of moderately complex and occasionally complex usual and customary billings
- Monitor treatment and benefit payments for excessive, unreasonable, or abusive claims
- Review and respond to pre-suit demand letters; analyzes claim and demand, and recommend whether settlement is warranted or claim should be referred to legal counsel
- Prepare for and attend (to testify at) depositions, hearings, trials, arbitrations, or mediations
What we offer:
- Competitive salary, based on prior experience
- Generous Paid Time Off, 401(k) and pension
- Medical, dental, and vision coverage
- Wellness incentives
- Tuition reimbursement (starts day 1)
- Volunteer opportunities
- You can view all Allstate benefits @ https://allstategoodlife.com
- Bachelors degree in related field preferred or equivalent experience
- RHIT Certification required
- Two or more years of medical claims experience preferred
- Ability to interact effectively with internal or external customers and act with empathy
- Apply knowledge of insurance policy, coverage, and regulation
- Beginning to apply knowledge of claim processes, policies, procedures, claim systems, coverage, liability, damage estimating, and/or settlement, and adherence to applicable legal compliance standards
- Beginning to apply ability to leverage learned technical skills in support of team objectives
- Beginning to apply negotiation and/or arbitration skills
- Beginning to apply conflict management and problem resolution skills in managing internal and external customer relationships
- Ability to investigate, evaluate, negotiate and settle basic and occasionally moderately complex claims
- Provides individual decision making within authority limits
- Has and maintains all appropriate licenses and registrations for the role per state requirements
- Miltary personnel suggested to apply
The candidate(s) offered this position will be required to submit to a background investigation, which includes a drug screen.
Good Work. Good Life. Good Hands.
As a Fortune 100 company and industry leader, we provide a competitive salary but thats 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, youll have access to a wide variety of programs to help you balance your work and personal life -- including a generous paid time off policy.
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Allstate generally does not sponsor individuals for employment-based visas for this position.
Effective July 1, 2014, under Indiana House Enrolled Act (HEA) 1242, it is against public policy of the State of Indiana and a discriminatory practice for an employer to discriminate against a prospective employee on the basis of status as a veteran by refusing to employ an applicant on the basis that they are a veteran of the armed forces of the United States, a member of the Indiana National Guard or a member of a reserve component.
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It is the policy of Allstate to employ the best qualified individuals available for all jobs without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity/gender expression, disability, and citizenship status as a veteran with a disability or veteran of the Vietnam Era.