Benefits Claims Coordinator - Client Advocate (Hybrid)

MST Insurance Solutions, Inc; Schaumburg (IL); Hybrid; USD 42,000 - 54,000; Full time

Job summary

MST Insurance Solutions, Inc. in Schaumburg, IL is hiring an Employee Benefits Claims Coordinator to support benefit claim processing and advocate for clients.

This entry-level role works with carriers, providers, and the account management team to resolve claim issues and ensure timely communication. You will learn about benefit plans, EOBs, pre-authorization, and claim status while delivering high-quality customer service.

Responsibilities

• Acts as a liaison between employees, insurance carriers, providers, and the Account Management Team to assist with the resolution of benefit claim issues.
• Researches claim inquiries and works with insurance carriers and other parties to identify the cause of claim processing issues and appropriate next steps.
• Assists employees with understanding Explanation of Benefits (EOB) statements, claim status, carrier requests for additional information, and other claim-related communications.
• Assists with denied, incorrectly processed, or outstanding medical, prescription drug, dental, vision, life, and disability claims.
• Assists employees with pre-authorization and prior authorization issues, including communicating with insurance carriers and healthcare providers to determine requirements, status, and next steps.
• Assists employees with benefit and coverage inquiries by reviewing available plan information and working with insurance carriers to confirm applicable benefits, limitations, and requirements.
• Works with insurance carriers to escalate claim issues when additional review or intervention is necessary.

Skills

Customer service

Communication

Problem solving

Insurance terminology

Job description

MST Insurance Solutions, Inc. in Schaumburg, IL is hiring an Employee Benefits Claims Coordinator to support benefit claim processing and advocate for clients.

This entry-level role works with carriers, providers, and the account management team to resolve claim issues and ensure timely communication. You will learn about benefit plans, EOBs, pre-authorization, and claim status while delivering high-quality customer service.