Claim Benefit Specialist

Job Description: • Reviews and adjudicates claims in accordance with claim processing guidelines • Enhances and improves member satisfaction and retention by providing accurate and timely resolution in processing medical claims • Determines and understands the coverage provided under a member's health plan • Efficiently uses multiple systems and screens to obtain and record claim information • Reviews claims information to determine the nature of a member's illness or injury • Identifies claim cost management opportunities and refers claims for follow up • Makes claim payment decisions • Processes claims accurately to enhance customer satisfaction and retention • Processes claims within quality and production standards • Assists team members in support of achieving team, office, regional, and national goals Requirements: • Experience in a quality and production environment • Attention to detail • Ability to use multiple computer applications at one time • Claim processing experience Benefits: • Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility Apply tot his job Apply To this Job