Claim Benefit Specialist
Job Description:
• Performs claim documentation review, verifies policy coverage, assesses claim validity
• Ensures accurate and timely claims processing
• Handles and processes Benefits claims submitted by healthcare providers
• Determines the eligibility and coverage of benefits for each claim
• Assesses claims for accuracy and compliance with coding guidelines
• Documents claim information in the company system
• Conducts reviews and investigations of claims
• Communicates with healthcare providers, patients, or other stakeholders to resolve discrepancies
• Develops and implements regular feedback and formal performance review process
• Analyzes claims data and generates reports
Requirements:
• 1-2 years’ experience working in Customer Service
• Possess strong teamwork and organizational skills
• Strong and effective communication skills
• Ability to handle multiple assignments competently through use of time management, accurately and efficiently
• Strong proficiency using computers and experience with data entry
• Experience in a production environment (preferred)
• Healthcare experience (preferred)
• Knowledge of utilizing multiple systems at once to resolve complex issues (preferred)
• Understanding of medical terminology (preferred)
• High School or GED equivalent
Benefits:
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access
Apply Now
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• Performs claim documentation review, verifies policy coverage, assesses claim validity
• Ensures accurate and timely claims processing
• Handles and processes Benefits claims submitted by healthcare providers
• Determines the eligibility and coverage of benefits for each claim
• Assesses claims for accuracy and compliance with coding guidelines
• Documents claim information in the company system
• Conducts reviews and investigations of claims
• Communicates with healthcare providers, patients, or other stakeholders to resolve discrepancies
• Develops and implements regular feedback and formal performance review process
• Analyzes claims data and generates reports
Requirements:
• 1-2 years’ experience working in Customer Service
• Possess strong teamwork and organizational skills
• Strong and effective communication skills
• Ability to handle multiple assignments competently through use of time management, accurately and efficiently
• Strong proficiency using computers and experience with data entry
• Experience in a production environment (preferred)
• Healthcare experience (preferred)
• Knowledge of utilizing multiple systems at once to resolve complex issues (preferred)
• Understanding of medical terminology (preferred)
• High School or GED equivalent
Benefits:
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access
Apply Now
Apply Now