Claims Examiner (Waukesha, WI)
Summary
The Claims Examiner processes health claims to completion in both paper and electronic form, responds to telephone inquiries from participants and providers, and resolves calls to completion, including investigating the issue and communicating final resolution. This is a union position.
Responsibilities
- Demonstrate consistent professional and amiable representation of the health plan and company
- Demonstrate consistent accuracy in providing benefit information
- Explain insurance benefits and payment in layman’s terms
- Verify system information for specific demographics or coverage
- Assist in other duties as assigned during any down time
- Process both paper and electronic claims to plan benefits/guidelines
- Regular and predictable attendance is an essential function of this job
Qualifications
- Superior communication skills
- Attention to detail and accuracy required
- Must be able to multi-task
- Microsoft Windows and Office Productions experience
- Strong organizational skills
- Knowledge of health insurance terminology and summary plan descriptions a plus
Education and/or Experience - High School diploma or GED required. Experience in a Customer Service Call Center is a plus. Experience in health insurance administration support or medical billing customer support preferred.
Language Skills - Ability to read documents and communicate professionally and clearly.
Mathematical Skills - Ability to apply concepts of basic addition, subtraction, multiplication, and division.
Reasoning Ability - Ability to apply common sense to carry out detailed written or verbal instructions.
Work Environment - The position operates in an office/clerical setting, using standard office equipment such as: computers, phones, photocopiers, filing cabinets, fax machines, etc. The department can be fast paced.
Physical Requirements - This position involves sustained periods of sitting and keyboarding. Some light lifting may also be required.
Work Schedule - Full time, Monday – Friday, 7:30am - 4:00pm. Required in-office; no remote work.
Benefits – This is a union position, and the benefits offered are determined by the collective bargaining agreement. They include:
- Health Insurance and short-term disability insurance
- 2 days paid vacation after 6 months, 5 days after 1 year, 10 days after 2 years
- 6 days paid sick time in first year, 12 days after 1 year
- 3 days paid bereavement leave
- 10 paid Company holidays and one floating holiday
- Defined contribution pension plan
- Voluntary 401(k) with employer match
Pay
This is a union position. The wage rate for this position is determined by the collective bargaining agreement and may be dependent on experience, skills, education and other business factors. The current minimum starting rate for this position is $24.99 per hour, with a minimum $0.50 per hour increase after six months.
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.
Please Note :
chrismaxcer.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, chrismaxcer.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.