Note: The job is a remote job and is open to candidates in USA. Reliance Matrix is dedicated to fostering an inclusive culture and is seeking an Absence Management Specialist. This role involves acting as a liaison between clients, employees, and healthcare providers, managing claims, and ensuring compliance with regulations while providing excellent customer service.
Responsibilities
- Investigates claim issues providing resolution within departmental and regulatory guidelines
- Interprets and administers contract provisions: eligibility and duration
- Accurately codes all system fields with correct financial, diagnosis and duration information
- Coordinates with other departments to ensure appropriate claims transition or facilitate timely return to work
- Adheres to compliance, departmental procedures, and Unfair Claims Practice regulations
- Actively contributes to customer service, quality and performance objectives
- Proactively engages in departmental training to remain current with all claim management practices
- Responsible for managing Performance Guarantee clients and meet targeted metrics
- Responsible and accountable for maintaining and protecting personal health information
- Must maintain a high level of confidentiality and abide by HIPPA rules and regulations
Skills
- High School Diploma or GED (Bachelor's preferred)
- Ability to develop proficiency regarding required RSL products, systems and processes related to the effective delivery of new business proposals
- Microsoft Office experience
- Attention to detail, analytical skills, and the ability to collaborate with others and work independently
- Strong organizational skills, including the ability to prioritize work and multi-task
- Customer service experience and orientation
- Written and verbal communication skills
Benefits
- An annual performance bonus for all team members
- Generous 401(k) company match that is immediately vested
- A choice of three medical plans (that include prescription drug coverage) to suit your unique needs.
- For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account
- Multiple options for dental and vision coverage
- Company provided Life & Disability Insurance to ensure financial protection when you need it most
- Family friendly benefits including Paid Parental Leave & Adoption Assistance
- Hybrid work arrangements for eligible roles
- Tuition Reimbursement and Continuing Professional Education
- Paid Time Off – new hires start with at least 20 days of PTO per year in addition to nine company paid holidays.
- As you grow with us, your PTO may increase based on your level within the company and years of service.
- Volunteer days, community partnerships, and Employee Assistance Program
- Ability to connect with colleagues around the country through our Employee Resource Group program
Company Overview
- Reliance Matrix provides financial protection, absence management, and supplemental health benefits solutions. It was founded in 1907, and is headquartered in Philadelphia, Pennsylvania, USA, with a workforce of 1001-5000 employees. Its website is https://reliancematrix.com.