Claims Representative II – Health & Dental

Role Overview

• keying, processing health claims in accordance with claims policies and procedures
• able to handle more complex claim with a good understanding of the application of benefit contracts, pricing, processing, policies, procedures, government regs, coordination of benefits, healthcare terminology
• adjust claims
• reviews, analyzes and processes claims/policies related to events to determine extent of company's liability and entitlement
• researches and analyzes claims issues
• responds to inquiries, may involve customer/client contact

Requirements

• Requires a HS diploma or equivalent
• minimum of 1 year of claims processing experience
• previous experience using PC, database system, and related software (word processing, spreadsheets, etc.)
• or any combination of education and experience which would provide an equivalent background

Benefits

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution
• paid holidays
• Paid Time Off
• medical, dental, vision benefits
• short and long term disability benefits
• wellness programs
• financial education resources