Claims Examiner (Waukesha, WI)

Company: BeneSys, Inc.
Location: Waukesha
Posted on: May 22, 2023

Job Description:

Claims Examiner (Waukesha, WI)SummaryThe Claims Examiner processes health claims to completion in both paper and electronic form, responds to telephone inquiries from participants and providers, and resolves calls to completion, including investigating the issue and communicating final resolution. This is a union position.ResponsibilitiesDemonstrate consistent professional and amiable representation of the health plan and companyDemonstrate consistent accuracy in providing benefit informationExplain insurance benefits and payment in layman's termsVerify system information for specific demographics or coverageAssist in other duties as assigned during any down timeProcess both paper and electronic claims to plan benefits/guidelinesRegular and predictable attendance is an essential function of this jobQualificationsSuperior communication skillsAttention to detail and accuracy requiredMust be able to multi-taskMicrosoft Windows and Office Productions experienceStrong organizational skillsKnowledge of health insurance terminology and summary plan descriptions a plusEducation and/or Experience - High School diploma or GED required. Experience in a Customer Service Call Center is a plus. Experience in health insurance administration support or medical billing customer support preferred.Language Skills - Ability to read documents and communicate professionally and clearly.Mathematical Skills - Ability to apply concepts of basic addition, subtraction, multiplication, and division.Reasoning Ability - Ability to apply common sense to carry out detailed written or verbal instructions.Work Environment - The position operates in an office/clerical setting, using standard office equipment such as: computers, phones, photocopiers, filing cabinets, fax machines, etc. The department can be fast paced.Physical Requirements - This position involves sustained periods of sitting and keyboarding. Some light lifting may also be required.Work Schedule - Full time, Monday - Friday, 7:30am - 4:00pm. Required in-office; no remote work.Benefits - This is a union position, and the benefits offered are determined by the collective bargaining agreement. They include:Health Insurance and short-term disability insurance2 days paid vacation after 6 months, 5 days after 1 year, 10 days after 2 years6 days paid sick time in first year, 12 days after 1 year3 days paid bereavement leave10 paid Company holidays and one floating holidayDefined contribution pension planVoluntary 401(k) with employer matchPayThis is a union position. The wage rate for this position is determined by the collective bargaining agreement and may be dependent on experience, skills, education and other business factors. The current minimum starting rate for this position is $24.99 per hour, with a minimum $0.50 per hour increase after six months.Our CultureBeneSys wants to be a great service provider to the members we serve, and we recognize we can only do that if we are also a great employer with successful employees. In short, our success is driven by our employees' successes. We want to be a place where people want to work, feel proud of what they do and feel fulfilled both professionally and personally. We want to create a place where employees can find long-term growth and potential.Our culture focuses on three core values:Collaboration: working together across 31 locations to achieve the best for the company and our clientsDedication: striving to create an environment where all employees work toward a common goal while committing to providing the best customer service to our members and our colleaguesIntegrity: doing what we say we will do. Upholding strong ethical and moral principlesADA & EEOReasonable accommodations will be made so that qualified individuals with disabilities are able to complete the application process and, if hired, fulfill the essential functions of their job.

Keywords: BeneSys, Inc., Waukesha , Claims Examiner (Waukesha, WI), Other , Waukesha, Wisconsin