Claims Examiner I
Job Description:
• Under general supervision, assesses claim information, references contracts and performs calculations and other functions to accomplish the processing and payment of insurance claims of a complicated or non-routine nature
• Interprets contract information and communicates with outside parties to obtain information and coordinate coverage
• Performs claim research and adjustments
• Successfully completes all training programs as required for the level
• Processes claims for two products or claim types (dental, hospital, medical, ITS, FEP)
• Responds to written inquiries from internal and external customers as business needs dictate
Requirements:
• High school diploma or general education degree (GED)
• 2 years of previous customer service, member services, or claims processing experience; or any combination of required education and experience
• Advanced Keyboarding Knowledge
• Intermediate knowledge of Microsoft Office
• Knowledge of FACETS and/or other computerized claims processing system as applicable (FEP)
• Associates degree from college or technical school
Benefits:
• Highly competitive total rewards package, including comprehensive medical, dental and vision benefits as well as a 401(k) plan that both the employee and employer contribute
• Annual incentive bonus plan based on company achievement of goals
• Time away from work including paid holidays, paid time off and volunteer time off
• Professional development courses, mentorship opportunities, and tuition reimbursement program
• Paid parental leave and adoption leave with adoption financial assistance
• Employee discount program
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• Under general supervision, assesses claim information, references contracts and performs calculations and other functions to accomplish the processing and payment of insurance claims of a complicated or non-routine nature
• Interprets contract information and communicates with outside parties to obtain information and coordinate coverage
• Performs claim research and adjustments
• Successfully completes all training programs as required for the level
• Processes claims for two products or claim types (dental, hospital, medical, ITS, FEP)
• Responds to written inquiries from internal and external customers as business needs dictate
Requirements:
• High school diploma or general education degree (GED)
• 2 years of previous customer service, member services, or claims processing experience; or any combination of required education and experience
• Advanced Keyboarding Knowledge
• Intermediate knowledge of Microsoft Office
• Knowledge of FACETS and/or other computerized claims processing system as applicable (FEP)
• Associates degree from college or technical school
Benefits:
• Highly competitive total rewards package, including comprehensive medical, dental and vision benefits as well as a 401(k) plan that both the employee and employer contribute
• Annual incentive bonus plan based on company achievement of goals
• Time away from work including paid holidays, paid time off and volunteer time off
• Professional development courses, mentorship opportunities, and tuition reimbursement program
• Paid parental leave and adoption leave with adoption financial assistance
• Employee discount program
Apply tot his job
Apply To this Job