Medical Claims Representative at Webster

Claims Representative; Account Services

Department: Claims Department

Reports To: Flexible Benefits Manager
FLSA Status: Non-Exempt

Employment Status: Full-Time; Monday-Friday 8:30-5:00

Salary: $30,000-$35,000; based on experience

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Position Summary:

Process and pay claims, provide assistance to customers and support to the Claims Department Staff.

Essential Duties and Responsibilities

Examine, process, calculate, and pay claims insuring

Complies with state regulatory laws, policies, and company procedures.

Assists claimants, providers, and clients with problems or questions regarding their claims and/or policies

Key HRA and FSA claim data

Compiles and prepares data/research as it relates to escalating claims issues involving the deductible accumulator to then be assigned to another member within the claims department

Processes both adds and terms within DataPath 125 and 105

Composes SBCs for Employer groups

Performs other work-related duties as assigned.

Minimum Qualifications (Education, Experience, Skills)

Bachelors degree or equivalent

NYS Licensed in Life, Accident & Health is preferred*

6 - 12 months of related experience and/or training

Working knowledge of Microsoft Office applications; Word, Excel, Outlook

Ability to read and understand medical terminology and insurance claims as well as interpret documents such as medical bills, EOBs (Explanation of Benefits), etc

Proficient mathematical skills as it applies addition, subtraction, multiplication and division

Ability to work in a fast paced environment with a fluctuating workload

Excellent communication skills; both written and verbal

Ability to work effectively within a team and independently

*Special Note: New York State Licensing in Life, Accident & Health will be required within the first three months of employment should it be found that the ideal candidate for the position does not already hold an active license. The training course and testing will be provided.

Country: USA, State: New York, City: Webster, Company: Company Confidential.