Clearwater, Florida, United States · Hybrid
Health Insurance Claims Adjuster Insurance Administrative Solutions Clearwater, FL About Insurance Administrative Solutions Insurance Administrative Solutions, L.L.C. (“IAS”), an Integrity company headquartered in Clearw…
Skills: Claims adjudication, Health insurance, Medical terminology, UB/institutional claims, HCFA/professional claims
Clearwater, Florida, United States · Hybrid
Premium Accounting Associate Insurance Administrative Solutions Clearwater, FL About Insurance Administrative Solutions Insurance Administrative Solutions, L.L.C. (“IAS”), an Integrity company headquartered in Clearwater…
Skills: Accounting, Bookkeeping, Cash Receipts, Cash Disbursements, General Ledger
Clearwater, Florida, United States · Hybrid
Treasury Associate Location: IAS Headquarters - Clearwater, FL Join Insurance Administrative Solutions (IAS) - a proud member of the Integrity family of companies offering unrivaled insurance administrative services! IAS…
Skills: Banking Deposit Operations, Treasury Management, Accounting, Microsoft Office, Excel
Clearwater, Florida, United States · Hybrid
Medicare Supplement Underwriter & Applicant Interviewer Location: IAS Headquarters - Clearwater, FL Join Insurance Administrative Solutions (IAS) - a proud member of the Integrity family of companies offering unrivaled i…
Skills: Underwriting, Applicant Interviewing, Medical Terminology, Pharmaceutical Knowledge, Phone Handling
Clearwater, Florida, United States · On-site
Insurance Customer Service Commission Associate Insurance Administrative Solutions Clearwater, FL About Insurance Administrative Solutions Insurance Administrative Solutions, L.L.C. (“IAS”), an Integrity company headquar…
Skills: Customer Support, Commission Processing, Microsoft Office, Active Listening, Communication
Clearwater, Florida, United States • Hybrid
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The adjuster will analyze medical claims to determine insurance carrier liability and interpret contract benefits according to processing guidelines. They are also responsible for investigating potential fraud or waste and maintaining contact with providers, agents, and policyholders.
Candidates must have a high school diploma or GED and at least one year of proven health insurance claims adjudication experience. Proficiency with CMS-1450 and CMS-1500 claim forms, medical terminology, and Microsoft Office is required.
Insurance Administrative Solutions, L.L.C. (“IAS”), an Integrity company headquartered in Clearwater, Florida, is a third-party administrator providing business process outsourcing for insurance carriers. Formed in 2002, IAS administers policies for insureds residing all across the United States.
Job Summary: Analyze medical claims to determine the extent of insurance carrier liability. Interpret contract benefits in accordance with specific claims processing guidelines.
Primary Responsibilities other duties may be assigned as necessary:
Examine/perform/research & make decisions necessary to properly adjudicate claims and written inquiries.
Receive, organize and make daily use of information regarding benefits, contract coverage, and policy decisions.
Interpret contract benefits in accordance with specific claim processing guidelines.
Coordinate daily workflow to coincide with check cycle days to meet all service guarantees.
Based on established guidelines and/or historical knowledge an adjuster will need to recognize red flags for potential fraud or waste and escalate accordingly.
Adjusters who handle the potential fraud or waste claims will investigate, track via clear and complete system notes and accurately report on each file/case in a timely manner.
Understand broad strategic concept of our business and link these to the day-to-day business functions of claims processing.
Maintain external contact with providers/agents/policyholders.
Primary Skills & Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
A high school diploma or GED equivalent
Minimum of 1 year proven health insurance claims adjudication experience.
Insurance background preferred; previous Medical/prescription claims preferred.
Experience with UB/institutional (CMS-1450) and HCFA/professional (CMS-1500) claims required.
Familiarity with medical terminology, procedures and diagnosis codes preferred.
Ability to read and interpret EOB’s claim history, and excellent research skills.
Familiarity with Microsoft Office products; familiarity with Qiclink software a plus.
Ability to calculate deductible and co-insurance amounts.
Ability to adapt and respond to different types of people and tasks.
Excellent communication and documentation skills.
Ability to multi-task, prioritize, and manage time effectively and efficiently.
Reliable transportation and the ability to be punctual and dependable.
We value flexibility and recognize the importance of work‑life balance. This role will begin as fully onsite to support learning and team integration. As proficiency is demonstrated, hybrid work opportunities may be introduced, dependent on business needs and department practices.
Medical/Dental/Vision Insurance
401(k) Retirement Plan
Paid Holidays
Community Service PTO
Life Insurance
Short-Term and Long-Term Disability
Integrity is one of the nation’s leading independent distributors of life, health and wealth insurance products. With a strong insurtech focus, we embrace a broad and innovative approach to serving agents and clients alike. Integrity is driven by a singular purpose: to help people protect their life, health and wealth so they can prepare for the good days ahead.
Integrity offers you the opportunity to start a career in a family-like environment that is rewarding and cutting edge. Why? Because we put our people first! At Integrity, you can start a new career path at company you’ll love, and we’ll love you back. We’re proud of the work we do and the culture we’ve built, where we celebrate your hard work and support you daily. Joining us means being part of a hyper-growth company with tons of professional opportunities for you to accelerate your career. Integrity offers our people a competitive compensation package, including benefits that make work more fun and give you and your family peace of mind.
Headquartered in Dallas, Texas, Integrity is committed to meeting Americans wherever they are — in person, over the phone or online. Integrity’s employees support hundreds of thousands of independent agents who serve the needs of millions of clients nationwide. For more information, visit Integrity.com.
Integrity, LLC is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national origin, disability, veteran status, or any other characteristic protected by federal, state, or local law. In addition, Integrity, LLC will provide reasonable accommodations for qualified individuals with disabilities.
Insurance Administrative Solutions (IAS) offers unrivaled insurance administration services. Our knowledgeable and tenured personnel, rich in experience and domain knowledge, use proven methodologies and a unique combination of proprietary and commercial technology to ensure that your business is managed quickly and accurately, and your customers experience best-in-class service. We provide a full suite of end-to-end business processing services that can be customized to meet your unique business needs. More than just a third-party administrator, IAS is helping to shape the landscape of the insurance industry through public policy advocacy, innovative administrative solutions, consultative approach and commitment to service excellence. We are a thriving and growing business process outsourcing solution that helps insurers optimize administrative workload, bolster their industry expertise, leverage emerging technologies, and streamline operations. Mission: To provide competitive best of class Insurance Administrative Solutions to our clients while cultivating an exceptional work environment. INSURANCE PRODUCTS WE ADMINISTER: ▓▒░ MARKETS ░▒▓ Individual Insurance Group Insurance Worksite Benefits Voluntary Benefits ▓▒░ PRODUCTS ░▒▓ ▬▬ Medicare Supplement / Medigap ▬▬ ○ Pre-Standard ○ Standard ▬▬ Life & Annuity ▬▬ ○ Term Life ○ Universal Life ○ Whole Life ○ Final Expense ○ Burial / Industrial Insurance ○ Annuities ▬▬ Accident & Health Products ▬▬ ○ Accidental Death & Dismemberment ○ Hospital Indemnity ○ Limited Medical Expense ○ Personal Accident ○ Cancer ○ Critical Illness & Specified Disease ○ Convalescent Care ○ Short Term Disability ○ Other Supplemental Health Products
Offices: 17757 US HWY 19 N, Suite 660, Clearwater, Florida 33764, US · 1352 Redmond Circle NW, Rome, Georgia 30165, US
Insurance Administrative Solutions (IAS) offers unrivaled insurance administration services. Our knowledgeable and tenured personnel, rich in experience and domain knowledge, use proven methodologies and a unique combination of proprietary and commercial technology to ensure that your business is managed quickly and accurately, and your customers experience best-in-class service. We provide a full suite of end-to-end business processing services that can be customized to meet your unique business needs. More than just a third-party administrator, IAS is helping to shape the landscape of the insurance industry through public policy advocacy, innovative administrative solutions, consultative approach and commitment to service excellence. We are a thriving and growing business process outsourcing solution that helps insurers optimize administrative workload, bolster their industry expertise, leverage emerging technologies, and streamline operations. Mission: To provide competitive best of class Insurance Administrative Solutions to our clients while cultivating an exceptional work environment. INSURANCE PRODUCTS WE ADMINISTER: ▓▒░ MARKETS ░▒▓ Individual Insurance Group Insurance Worksite Benefits Voluntary Benefits ▓▒░ PRODUCTS ░▒▓ ▬▬ Medicare Supplement / Medigap ▬▬ ○ Pre-Standard ○ Standard ▬▬ Life & Annuity ▬▬ ○ Term Life ○ Universal Life ○ Whole Life ○ Final Expense ○ Burial / Industrial Insurance ○ Annuities ▬▬ Accident & Health Products ▬▬ ○ Accidental Death & Dismemberment ○ Hospital Indemnity ○ Limited Medical Expense ○ Personal Accident ○ Cancer ○ Critical Illness & Specified Disease ○ Convalescent Care ○ Short Term Disability ○ Other Supplemental Health Products
Offices: 17757 US HWY 19 N, Suite 660, Clearwater, Florida 33764, US · 1352 Redmond Circle NW, Rome, Georgia 30165, US
