Claims Intake Specialist

CLAIMS INTAKE SPECIALIST
(Full Time, Hourly, Non-Exempt)

Looking to join a growing company dedicated to helping others? We offer that, plus competitive salaries, a culture of learning, and a fast-paced environment. This is a hybrid position with 3 days in-office. Join our team to help make a difference in the lives of others!

About Continental General:

The Continental General family of companies has provided insurance, including life and long-term care policies, to individuals and groups for over 30 years, and currently supports over 100,000 policyholders. Both our insurance company, Continental General Insurance Company, and our third-party administrator, Continental General Services, are committed to the continuous development of our infrastructure, processes, and people. The group is actively growing through expansion of both its insurance portfolio and its administrative services.

With each opportunity, we take a collaborative approach to address challenges and provide unique solutions.

Position Summary:

We are seeking a full-time Claims Intake Specialist. Primary duties will be to assist customers with initiating claims under their Long-Term Care insurance policies. The Claims Intake Specialist educates customers on the claim process and their policy, gathers claim information and documentation, and partners with claim eligibility specialists to initiate claims in accordance with policy provisions, applicable regulations, and department procedures.

Key Responsibilities:

• Obtain pertinent information from new claimants by performing telephonic interviews and/or requesting claimant statements via email.
• Manage all requests by telephone and email, coordinate with clinical staff and claim eligibility specialists to ensure accuracy while providing support to both internal and external customers.
• Provide policy and claim information, assist with submission of claims and make outbound calls to gather missing information when incomplete documentation is received.
• Conduct research when needed to resolve customer questions or complaints.
• Manage outbound calls and letters to customers and providers to research incomplete claims.
• Process paperwork for new claimants efficiently and in accordance with department procedures.
• Document pertinent claim information and call summaries in the claim system and other applications.
• Contribute ideas to the team that enhance service quality.
• Comply with HIPAA and other regulatory requirements.
• Perform project work and other related duties as assigned or required.

Qualifications:

• High School Diploma or equivalent.
• Background in Healthcare Administration, Long Term Care or Health claims.
• 2 years of insurance industry customer service.
• Ability to communicate clearly and effectively, both verbally and in writing.
• Ability to handle customer interactions in a calm, professional, friendly and patient manner.
• Ability to work independently and utilize professional judgement to make accurate determinations and efficiently manage a multi-claim inquiry caseload.
• Ability to quickly adapt to changes either within the department or during the daily work assignments.
• Excellent organizational and time management skills.
• Ability to work in a team environment and display a positive attitude in an effort to meet department goals.
• Ability to work within a Windows Operating system and Microsoft Office Products.

• Competitive salary and benefits, including 401(k), health insurance, and performance-based bonuses.
• Collaborative and fast-paced work environment.
• Professional development and growth opportunities within the finance and investment space.
• Competitive Salary & Target Bonus Program.
• Retirement Savings – 401(k) with a company match.
• Comprehensive Medical insurance through Blue Cross Blue Shield of Texas. Company-paid dental, vision, short-term & long-term disability, and life insurance.
• Work-Life Balance – This role offers 20+ days of PTO, 10 paid holidays, and paid volunteer time off.
• Flexible Work Options & Perks – Hybrid opportunity, wellness programs, and weekly paid lunch for onsite staff.
• Health Savings Accounts (HSA) & Flexible Spending Accounts (FSAs) – Includes a company match for HSAs.