Claims Auditor

American Benefit Corporation is looking to add a detail-oriented, master multi-tasker to our team! Looking for a job with competitive pay and superb benefits? If your organizational skills are on point, you’re comfortable working with deadlines, and you are interested in growing your career in the health and benefits service industry – this job is a perfect fit for you!

Feel free to check the fine print of the job description below. If you’re interested, you can apply here on LinkedIn.

Position: Claims Auditor

Designation: Hourly Non-Exempt, Union

Location: Ona, West Virginia

Position Summary

American Benefit Corporation, a Third-Party Administrator of employee benefits and retirement funds, is looking to hire a Claims Auditor. This position would be ideal for recent graduates majoring in any of the following: Health Science, Health Informatics, Exercise Science, and related fields. Also, this position would be a great transition for anyone with work experience in medical or dental coding. Candidate must be a self-starter, adept multi-tasker, and capable of meeting strict deadlines.

Job Duties

• Examine claims and determine benefits in accordance with the plan provisions.

• Correspond with providers and participants, keeping accurate records of conversations and outcomes.

• Follow through regarding problems or requests resulting from phone inquiries in accordance with policies and procedures.

• Release checks and produce check registers as required.

• Provide claim totals to appropriate parties for bank transfers as needed.

• Maintain up-to-date claim information in group binders.

• File reinsurance claims for stop loss reimbursement.

• Test new groups or new benefits, which have been entered into the claims adjudication system for accuracy.

• Meet deadlines and adhere to schedules as required by position.

• Retrieve and file records, including records in storage as required.
• Maintains confidentiality during and post-employment.

• Reports to the job as scheduled.

• All other duties as assigned.

Necessary Skills

• Must be a detail-oriented worker.
• Must work efficiently and accurately with minimal supervision.
• Must meet strict deadlines.
• Knowledge of all Microsoft Office programs.
• Excellent communication skills, punctuality, and attendance.
• Must be a fast learner.
• Must be well organized.
• Ability to follow departmental and company procedures.
• Familiarity with medical terminology, including anatomy .
• Ability to multi-task and concentrate in a large office environment.
• Ability to organize and prioritize job responsibilities.

Education & Experience

• High School Diploma (or equivalent) is required; Bachelor’s Degree in related field is preferred.
• No prior experience is required, but 1-2 years of related experience is preferred.

Physical Requirements

The majority of this position will be completed in a stationary position; however, the person in this position needs to occasionally move about inside an office setting and across our ABC Campus.

Regularly operate a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer .

The person in this position must be able to regularly communicate accurate information.

Travel and Work Hours Requirements

This position rarely requires travel.

Usual work hours are standard Monday – Friday, 8:30 am to 5:00 pm.

E EO Statement

American Benefit Corporation is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

As such, we do not discriminate in employment on the basis of race, color, religion, sex, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, parental status, military service, or other non-merit factor.