Claim Benefit Specialist

Role Overview

• Performs claim documentation review
• Verifies policy coverage
• Assesses claim validity
• Communicates with healthcare providers and policyholders
• Ensures accurate and timely claims processing
• Handles and processes claims submitted by healthcare providers
• Determines eligibility and coverage of benefits
• Assesses claims for accuracy and compliance with coding guidelines
• Documents claim information in the company system
• Conducts reviews and investigations of claims
• Determines compliance with regulatory requirements

Requirements

• Proficient in basic computer operations and software applications
• Experience in a production environment
• Ability to performance metrics including production, quality, and turnaround time
• Possess strong teamwork and organizational skills
• Ability to multi-task
• Ability to work independently or as part of a group
• High School diploma or equivalent GED

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
• Financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access