Claims Clerk, Sr. jobs in Madison, WI

About the Company:

AssuranceSD is a mission-driven organization that offers administrative services to empower individuals to take control of their personal care services. Our mission is to help strengthen communities by enabling individuals to elect and manage their care programs, including how, when, where, and who delivers these services. This allows care recipients to retain their dignity during often challenging times and ensures they receive the most appropriate services for their situation. By facilitating self-directed home and community-based services, AssuranceSD significantly enhances the quality of home care available to aging seniors and individuals with special needs.

General Responsibilities:

The Claims Specialist is responsible for processing and auditing vendor claims to ensure accurate and timely processing. A Claims Specialist can use payroll software accurately and efficiently. The Claims Specialist must have strong analytical and critical-thinking skills to review and authorize claim payment and investigate unusual claims with solid attention to detail. Claims Specialists have excellent communication skills to interact with customers and colleagues. Dedication to maintaining high levels of accuracy and efficiency will directly contribute to ASD's mission of providing exceptional service to our customers and providers. The goal is to ensure personnel receive the correct compensation promptly.

AssuranceSD Benefit Package Includes:

• Competitive Pay
• Health insurance with Company Contributions
• HSA
• Holiday Pay
• Paid time off.
• Dental Insurance
• Vision insurance
• 401(k) with Company match
• Life insurance
• Long- and Short-Term Disability insurance
• Parental leave

Essential Duties and Responsibilities:

• Analyze and investigate vendor claims to help prevent fraud
• Resolve claims promptly through customer service calls and communications.
• Administer statements of payment to personnel electronically.
• Research and problem-solving.
• Audit claims process via quality control tests, random inspections, and writing reports documenting process issues.
• Maintain a filing system to retain all records and support reporting securely.
• Prepare and execute pay orders and administer statements of payment electronically.
• Maintain accurate records of payees, payments, and budgets for reporting purposes.
• Prepare and execute pay orders through an electronic system or distribute payments.
• Administer statements of payment to personnel either electronically or on paper.
• Prepare reports for upper management, finance department, etc.
• Performs other duties as assigned or needed.

Who You Are:

• Extensive knowledge of claims processing procedures, regulations, and best practices.
• Ability to effectively use computer software, including Microsoft Outlook, Word, and Excel; experience with fiscal management service software is a plus.
• Excellent organizational skills and attention to detail.
• Analytical mindset with the ability to use data to identify trends, make informed decisions, and drive process improvements.
• Experience with complex operational projects requiring critical thinking and advanced problem-solving to handle ambiguity

Equal Employer Opportunity Statement We are an equal opportunity workplace, committed to equal employment opportunity regardless of race, color, religion, national origin, age, sex, marital status, ancestry, physical or mental disability, genetic information, veteran status, gender identity or expression, sexual orientation, or any other characteristic protected by applicable federal, state or local law. We are committed to diversity, equity, and inclusion in our hiring practices and our experiences as an AssuranceSD employee. We strive to create a mindful and respectful environment where everyone can bring their authentic self to work and experience a culture free of harassment, racism, and discrimination.

Disclaimer: This job description indicates the general work necessary to execute core job responsibilities adequately adequately. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job.