Claims Examiner
Job Posting for Claims Examiner at Hueman PE Talent Solutions
Benefit Plan Administrators is hiring a fully remote Claims Examiner to join their team!
A Claims Examiner corresponds with policyholders, insurers, and providers to adjudicate claim payments
based on the schedule of benefits stated in the plan documents.
Job Requirements:
- Responsible for claim administration of assigned employer groups in accordance with plan
document and department/company policies and procedures. - Claim administration includes but is not limited to:
Adjudication of new, incoming claims
Adjustments, including denied claims upon receipt of requested information
Appeals
Management of inventory/turnaround time.
Subrogation/Third Party Liability
Meet minimum, established production standards on a monthly basis
Meet minimum, established financial and procedural accuracy standards on a monthly basis
Answers emails and other inquiries within established company timeframes
Ensure claims processed within stop loss contract terms
Follow up on missing/needed information to complete claims
Other duties as assigned
Job Qualifications:
- High School Diploma or G.E.D. equivalent
- At least Three (3) years of experience in insurance claim processing
- Knowledge of CPT Coding
- Knowledge ICD-10 codes
- Basic understanding of medical terminology
- Excellent communication skills
- Excellent customer service skills
- Computer proficiency with office applications
- Ability to comply with all company policies and procedures, proactively protecting the confidentiality of Client and company information
- Ability to work on a computer for a prolonged amount of time
- Ability to work overtime as needed based on industry demands
- Ability to multi-task and prioritize
- Ability to work with minimal direction or supervision
- Legally able to work in the United States
If you are interested in learning more about a career with BPA as a Claims Examiner, apply today!
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