Claims Examiner (Milwaukee, WI)
Summary - Processes routine medical, dental, vision and HRA claims and provide customer service, including providing information to hospitals, physicians and participants regarding eligibility, benefits and claims status.
Essential Duties and Responsibilities include but not limited to
- Process routine medical, dental, vision, HRA claims in accordance to plan benefits.
- Provide customer service by responding to and documenting telephone and/or written inquiries.
- Consistently meet established performance standards, including quantity and quality claims processing standards.
- Maintain current knowledge of assigned Plan(s) and effectively apply knowledge in the payment of claims, customer service, and all other job functions.
- Regular and predictable attendance is an essential function of this job.
Education and/or Experience
- High School diploma or equivalent required.
- Basic knowledge of benefits claims adjudication principles and procedures, medical and/or dental terminology and ICD-9 and CPT-4 codes.
Qualifications
- Claims examiner experience, preferred.
- Proficient with computers including keyboarding including 10-key (demonstrated ability to type quickly and accurately) and use of Microsoft Word, Outlook, and Excel.
- Provide excellent verbal and written communication skills and be capable of responding to high quality customer inquiries.
- Possess a strong work ethic and team player mentality.
- Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.
- Ability to calculate figures and amounts such as discounts, interest, proportions, and percentages.
- Strong decision-making, problem-solving, organizational skills and able to work in a “team” environment.
Work Schedule - Full-time. Monday – Friday, 8:00am - 4:30pm. Requires in-office days with possibility of one work from home day per week after full training.
Competitive Benefits and Compensation Package
- Paid Time Off (PTO)
- Pro-rated during first year of employment
- 15 days of PTO provided in the next calendar year!
- 11 paid holidays
- Health insurance, includes dependent coverage
- Employer-paid term life insurance
- Tuition reimbursement
- Long term disability insurance
- Career development opportunities
- 401k with employer match
Pay
The pay range is $54,000 - $58,000 per year and is dependent on location, experience, skills, education and other business factors.
Our Culture
BeneSys wants to be a great service provider to the members we serve, and we recognize we can only do that if we are also a great employer with successful employees. In short, our success is driven by our employees’ successes. We want to be a place where people want to work, feel proud of what they do and feel fulfilled both professionally and personally. We want to create a place where employees can find long-term growth and potential.
Our culture focuses on three core values:
- Collaboration: working together across 31 locations to achieve the best for the company and our clients
- Dedication: striving to create an environment where all employees work toward a common goal while committing to providing the best customer service to our members and our colleagues
- Integrity: doing what we say we will do. Upholding strong ethical and moral principles
ADA & EEO
Reasonable accommodations will be made so that qualified individuals with disabilities are able to complete the application process and, if hired, fulfill the essential functions of their job.