Quality Audit Analyst (LTD or STD claims) Job Listing at HCSC in Amarillo, TX (Job ID R0029592-TX - Amarillo)

Description

At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.

Come join us and be part of a purpose driven company who is  invested in your future!

Job Summary This position is responsible for planning and conducting detailed audits, analyzing programs, conducting training, coaching and managing projects related to quality. Review new business, changes, terminations, claims, customer telephone calls, billing, premium application, and commission processes to assure that: a) Internal controls and Model Audit Rule requirements are adhered to b) Processing is performed timely, accurately, and completely in the appropriate systems, and c) Disability coding and liability decisions are accurate, utilizing all appropriate risk resources. JOB REQUIREMENTS:

• Bachelor's degree or equivalent of 4 years of group disability insurance industry job experience.
• Analytical and research skills.
• Disability knowledge of NAIC, ERISA, and state regulations.

• Technical claims expertise and accuracy in product knowledge of life, AD&D, STD, and LTD.
• Technical claims expertise and accuracy in knowledge of group life and disability contracts.
• Ability to work independently and within a team environment.
• Applies best practices and knowledge of internal/external business challenges to improve products, processes, or services.
• Solves complex problems; takes a new perspective on existing solutions to improve performance and efficiency.
• Works to build consensus with internal/external peers in customer, and/or regulatory organizations.
• Proven ability to work well in a high visibility environment.

• Clear and concise written and verbal communication skills.

• Experience in making complex decisions independently, with minimal supervision.
• Organizational and multi-tasking skills to manage daily work load and meet aggressive deadlines and timetables.
• Knowledge of state contract provisions.
• Knowledge with sold case materials, departmental documents.

• PC proficiency to include Word, Excel and lotus Notes.
• Ability to demonstrate flexibility.
• Ability to effectively manage conflict.
• Ability to provide direct and candid feedback effectively while maintaining strong partnerships.

PREFERRED JOB REQUIREMENTS:

• 1 year of experience in the FDL environment.
• Experience with the following systems: Genelco, Enterprise Content Management (ECM), EAS, DCS, STAR
• Minimum of 2 years of Group Disability claims adjudication background.

We encourage people of all backgrounds and experiences to apply. Even if you don't think you are a perfect fit, apply anyway - you might have qualifications we haven't even thought of yet. **Please note that this role requires that you work in office at least 3 days a week

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

HCSC Employment Statement:

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

 Apply on company website