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 balanceStabilityCollaborative decision-makingQuirky, relaxed work environmentwe want to talk to you.DUTIESProcess medical, dental, and vision claims with speed and accuracyProfessionally respond to member and provider requests via telephone, email, and in-personAssess and resolve problems within the scope of authority, escalate complex problems to senior staffEmploy clarity, efficiency and compassion when communicating with clientsClearly document all customer contactsSupport other claims examiners and administrative team as neededQUALIFICATIONSHS Diploma, college degree preferredTwo years claims experience in a healthcare environmentCustomer service experience preferred Excellent written and verbal communication skillsKnowledge of medical terminology, billing, and IDC-10 and CPT codesKeen attention to detail; analytically and mathematically inclinedProficiency in Microsoft Office suiteExcellent time-management, problem-solving, and organizational skills Must be mature, reliable, have a stellar work ethic, and also possess enthusiasm, initiative, and curiosityPatience and sense of humor are equally essential