[Remote] Claims Support Specialist (Remote)

Note: The job is a remote job and is open to candidates in USA. Davies North America is a company that blends technology with professional services in the insurance sector. They are seeking an experienced Claims Support Specialist to provide administrative support for processing and managing insurance claims, including client data management and assisting in the claim evaluation process.

Responsibilities

• Verify and manage client data in IDEAS (claim administration system)
• Set up and manage claim billing in TSheets, including changes, accounting notices, and split bill notifications for multiple clients
• Complete funding allocation spreadsheets and manage off-cycle invoice processing
• Assist with preparation of Bordereaux (BDX) reports containing both claim and financial data
• Conduct sanctions checks for international claims
• Run weekly, monthly, and quarterly IDEAS reports for management review
• Manage client data distribution lists and support ad hoc/periodic client report requests
• Maintain complaint logs for client reporting
• Prepare and send initial claim forms packets and notifications emails to clients
• Assist in administration of major medical, student accident, and/or long-term duration disability claims
• Enter monthly expenses for investigative and medical records fees approved by claim adjusters
• Gather and review proof of loss
• Assess benefit eligibility and process benefit payments
• Manage client communications/claim report updates as needed
• Provide timely and thorough communication to clients and insureds
• Support ongoing handling of disability with long-term or repetitive pay duration
• Process eligible benefits
• Obtain, review, and verify periodic proof of loss
• Maintain client communications and claim report updates

Skills

• High school diploma/GED with some claim-related or industry experience (e.g., long-term care, disability insurance) preferred, or equivalent combination of education and experience
• Experience with medical reimbursements for accidents
• Excellent communication skills
• Strong attention to detail and organizational skills
• Self-motivated with the ability to work independently and take initiative
• Strong follow-through and ability to manage processes holistically
• Proficiency in Excel (i.e. formulas, filters, and data comparisons)

Benefits

• Medical, dental, and vision plans to support your health and that of your family
• A 401(k) plan with employer matching
• Time‑off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non‑exempt employees
• Paid holidays
• Life insurance and short‑term and long‑term disability coverage
• Paid sick leave
• Paid family and parental leave

Company Overview