Health Benefits Claims Examiner
Job Description:
- Ensure accuracy of claims adjudication while maintaining quality and turn around goals.
- Adjudicate medical, dental and vision claims.
- Review plan documents for various groups to apply appropriate benefits to claims being adjudicated.
- Prioritize assigned claims by adjudicating oldest claims first.
- Communicate effectively with internal auditors and management team.
- Perform other related duties, as assigned.
Requirements:
- At least 6 months prior experience in the healthcare or insurance industry with respect to operations support, including provider maintenance, billing, coding, or customer support.
- Experience in health care billing or a background with a health insurance carrier or Third-Party Administrator strongly desired.
- Solid time-management skills, with the ability to prioritize multiple tasks, while working with a sense of urgency.
- Strong interpersonal skills with excellent verbal and written communication skills.
- Keyboard and Windows skills are a must.
- Ability to work using Excel spreadsheets.
- Eager to learn the TPA industry and new concepts and processes.
- Blue Care experience and medical coding and terminology a plus.
Benefits:
- Fantastic medical, dental, and vision insurance*
• Twice annual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible!
- Company provided Basic Life and AD&D
- Company paid Short-Term and Long-Term Disability**
• Flexible Spending Accounts* • 401(k) Retirement Plan with up to a 6% employer-match** WOW! (100% fully vested after 3 years)
- 10+ paid holidays
- Generous paid vacation and sick time
- Annual Volunteer Paid Day
- Annual Tuition Reimbursement
- Annual Health and Wellness Reimbursement
- Lots of fun company events
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