Senior Claim Benefit Specialist

Description: reviews, researches and adjudicates complex, sensitive, and/or specialized encounters in accordance with State driven encounter processing guidelines. May be required to learn multiple Medicaid plans. Works to research and resolve encounter errors Ensures all compliance requirements are met. Identifies and reports possible claim overpayments, underpayments, scanning issues and any other irregularities.Requirements: 2 years Medical Claims processing experience adjudicating claims (Commercial, Medicaid, Medicare, etc.) Experience in a production environment. Analytical skills, with the ability to research particularly in areas involving rejected claims. Demonstrated ability to handle multiple assignments competently, accurately, and efficiently. Demonstrated proficiency with personal computer, keyboard navigation skills, and MS Office Suite applications. Preferred Qualifications QNXT claims processing experience Encounters experience Edifecs knowledge.Benefits: Affordable medical plan options a 401(k) plan (including matching company contributions) an employee stock purchase plan No-cost programs for all colleagues including wellness screenings tobacco cessation and weight management programs confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off flexible work schedules family leave dependent care resources colleague assistance programs tuition assistance retiree medical access and many other benefits depending on eligibility.

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