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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