Claims Examiner/Member Services Representative

Job Description

Job Description

Small Health and Welfare Claims Administrator seeks full-time Claims Examiner/Member Services Representative to process claims and provide outstanding customer service to external and internal clients. This is a full-time, in-office position during the initial training period converting to hybrid work after the training period is completed.

Successful candidate must be detail oriented, possess excellent interpersonal skills, be a master communicator, and demonstrate a strong desire to assist others and continuously learn.

If you value . . .

• Work/life balance
• Stability
• Collaborative decision-making
• Quirky, relaxed work environment

we want to talk to you.

DUTIES

• Process medical, dental, and vision claims with speed and accuracy
• Professionally respond to member and provider requests via telephone, email, and in-person
• Assess and resolve problems within the scope of authority, escalate complex problems to senior staff
• Employ clarity, efficiency and compassion when communicating with clients
• Clearly document all customer contacts
• Support other claims examiners and administrative team as needed

QUALIFICATIONS

• HS Diploma, college degree preferred
• Two years claims experience in a healthcare environment
• Customer service experience preferred
• Excellent written and verbal communication skills
• Knowledge of medical terminology, billing, and IDC-10 and CPT codes
• Keen attention to detail; analytically and mathematically inclined
• Proficiency in Microsoft Office suite
• Excellent time-management, problem-solving, and organizational skills
• Must be mature, reliable, have a stellar work ethic, and also possess enthusiasm, initiative, and curiosity
• Patience and sense of humor are equally essential