Claims Administrator

Key Family of Companies; Mettawa (IL); Remote; USD 40,000 - 70,000; Full time

Job summary

An established industry player is seeking a Claims Administrator to join their remote team. This role involves providing accurate healthcare claims adjudication, ensuring compliance with plan provisions, and delivering outstanding customer service. The company prides itself on a supportive culture and has been recognized as a Top Workplace since 2013. If you have experience in medical claims processing and are looking for a collaborative environment, this opportunity is perfect for you!

Qualifications

• 3-5 years of experience in processing medical claims.
• Strong computer skills and knowledge of Microsoft Excel and Word.

Responsibilities

• Provide accurate and timely healthcare claims adjudication.
• Determine eligibility and covered benefits for services.
• Maintain performance standards for accuracy and turnaround time.

Skills

Medical Claims Processing

Communication Skills

Organizational Skills

Problem-Solving Skills

Medical Terminology

Microsoft Excel

Microsoft Word

Multi-tasking

Job description

Key Benefit Administrators is currently seeking an experienced Claims Administrator to join our team. We are excited to speak to qualified claims administrator candidates about this opportunity. This will be a remote position and includes a comprehensive benefit package and competitive salary!

About Key Benefit Administrators

We are on a mission to improve health and stabilize insurance costs for local communities. KBA was founded in 1979 as a privately owned full-service group benefit administration firm specializing in self-funded medical plans and is now one of the country's largest independently owned third party administrators. We pride ourselves on having supportive leadership, a family atmosphere, and a high performing culture - ask our employees - they have agreed that we are a Top Workplace since 2013.

Check us out here:

https://keybenefit.com/

https://www.glassdoor.com/Overview/Working-at-Key-Benefit-Administrators-EI_IE692314.11,37.htm

https://topworkplaces.com/company/key-benefit-administrato/indystar/

Day in the Life

A successful Claims Administrator will provide accurate and timely healthcare claims adjudication for our clients as dictated by the plan provisions in accordance with established procedures and processes.

Essential Duties and Responsibilities:

• Reviews claims for all detail required to process claims submissions. Requests additional information as appropriate.
• Determines eligibility and covered benefits for services in accordance with plan provisions.
• Adjudicates claims for payment/denial in accordance with procedures and processes.
• Develops an understanding of plan documents and amendments for assigned groups.
• Identifies system problems in processing and communicates to appropriate area for correction.
• Maintains the performance standard set for the client group for accuracy and turnaround time.
• Responds within designated turnaround time to Customer Service personnel and other Key Family employees on claim issues.
• Provides outstanding customer service to fellow employees and clients.
• Provides support as scheduled for Customer Service.

Does this sound like you?

• 3 - 5 years of experience in processing medical claims for self-insured and/or fully insured clients is essential. Some Third-Party Administrator and claims system experience required.
• Good verbal and written communication skills.
• Organizational and problem-solving skills with ability to analyze information to determine resolutions in accordance with procedures.
• Medical Terminology.
• Strong computer keyboard and navigational skills. Knowledge of Microsoft Excel and Word.
• Ability to multi-task in a fast-paced environment.
• Applicants for part-time positions must be available on a full-time basis for a six-week training program.

If you are unable to complete an application for Claims Administrator position due to a disability, contact Human Resources by calling 800-560-3539 to ask for an accommodation or an alternative application process.

All qualified applicants for the Operational Support Auditor - Claims position will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender.

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