About this role

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.

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.

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

Health Benefits Claims Examiner

Key skills