Health Benefits Claims Examiner

This is a fully remote position, open to applicants in Florida.

📋 Description

• Ensure the precision of claims adjudication while upholding quality and turnaround objectives.

• Adjudicate claims related to medical, dental, and vision services.

• Examine plan documents for various groups to apply the correct benefits to claims being processed.

• Prioritize claims by addressing the oldest ones first.

• Communicate effectively with internal auditors and the management team.

• Carry out other related tasks as assigned.

⛳️ Requirements

• Minimum of 6 months of previous experience in the healthcare or insurance sector related to operations support, including provider maintenance, billing, coding, or customer service.

• Experience in healthcare billing or familiarity with a health insurance carrier or Third-Party Administrator is highly preferred.

• Strong time-management abilities, with the capacity to prioritize various tasks while maintaining a sense of urgency.

• Excellent interpersonal skills, complemented by strong verbal and written communication abilities.

• Proficiency in keyboarding and Windows is essential.

• Capability to work with Excel spreadsheets.

• Willingness to learn about the TPA industry along with new concepts and processes.

• Experience with Blue Care and knowledge of medical coding and terminology is an advantage.

🏝️ Benefits

• Outstanding medical, dental, and vision insurance*

• Biannual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible!

• Basic Life and AD&D coverage provided by the company

• Company-paid Short-Term and Long-Term Disability**

• Flexible Spending Accounts*

• 401(k) Retirement Plan with an employer match of up to 6%** WOW! (100% fully vested after 3 years)

• More than 10 paid holidays

• Generous paid vacation and sick leave

• Annual Volunteer Paid Day

• Annual Tuition Reimbursement

• Annual Health and Wellness Reimbursement

• Numerous fun company events