Medical Claims Adjuster

Job Description

Job Description

Growing third party administrator of employee benefit funds is seeking Medical Claims Adjuster & Claims Customer Service Representative to join our Minneapolis office. In this dual role, you will be responsible for reviewing, processing, and adjudicating medical claims, while also providing exceptional customer service to policyholders, providers, and internal teams. The ideal candidate will have strong analytical skills, excellent communication abilities, and a customer-first mindset.

Experience with BSBS enGen platform, Microsoft Office software is required and computer proficiency is a must.

Position will be Full-Time and in person to start, with a hybrid schedule after training is completed.

Key Responsibilities:

• Process medical, dental and vision claims while achieving and maintaining quality and accuracy
• Assist in administrative duties in the claims department
• Read, analyze, understand and ensure compliance with clients’ SPD
• Learn, adhere to and apply all applicable privacy and security laws, including but not limited to HIPAA, HITECH and any regulations promulgated thereto
• Answer telephone calls from participants and providers with benefit questions
• Develop understanding of how benefits as described in SPD’s are input into claims software

To perform the job successfully, an individual should demonstrate the following:

• Customer Service – responds promptly to customer’s needs; manages difficult or emotional customer situations
• Business Acumen – understands business implications of decisions; aligns work with strategic goals
• Professionalism – approaches others in a tactful manner; reacts well under pressure; accepts responsibilities for own actions; follows through on commitments; team player
• Judgment – displays willingness to make decisions; exhibits sound and accurate judgment; supports and explains reasoning for decisions; includes appropriate people in decision-making process; makes timely decisions
• Quality – demonstrates accuracy and thoroughness; looks for ways to improve and promote quality; applies feedback to improve performance; takes pride in his/her own work
• Quantity – meets productivity standards; completes work in timely manner; strives to increase productivity
• Dependability – follows instructions, responds to management direction; keeps commitments
• Attendance/Punctuality – is consistently at work and on time; ensures work responsibilities are covered when absent
• Adaptability – adapts to changes in the work environment; ability to prioritize duties
• Planning/Organization – prioritizes and plans work activities; uses time efficiently

Ideal candidate would have 4+ years of claims paying experience, be a fast learner with strong attention to detail, be well organized and able to work with little supervision.

Benefits Management Group is a Third Party Benefits Administration Company working with building trade unions.

Our technology is what sets us apart. It is best in class. That means it is easy to use, accurate and efficient for our clients, their plan members and our own staff.

We believe that actions speak louder than words. We are a partner that our clients trust to deliver exceptional customer service, to simplify complicated issues and to provide accurate answers to questions.

Company Description

Benefits Management Group is a Third Party Benefits Administration Company working with building trade unions. \r\n\r\nOur technology is what sets us apart. It is best in class. That means it is easy to use, accurate and efficient for our clients, their plan members and our own staff.\r\n\r\nWe believe that actions speak louder than words. We are a partner that our clients trust to deliver exceptional customer service, to simplify complicated issues and to provide accurate answers to questions.