Claims Examiner / Customer Benefits Payment Representative

Beacon Hill Staffing Group, LLC; Saint Paul (MN); Hybrid; USD 39,000 - 44,000; Part time

Benefits offered by this job

Hybrid work arrangement

Job summary

Beacon Hill Staffing Group, LLC is seeking a detail-oriented Claims Examiner / Customer Benefits Payment Representative in St. Paul, MN. This hybrid role requires one onsite day and four remote days, working Monday through Friday from 8:00 AM to 4:45 PM with a 45-minute unpaid lunch.

The contract position focuses on accurate review, processing, and timely payment of customer benefit claims. The ideal candidate will have prior claims adjudication experience, excellent analytical and

Qualifications

• Experience with Employee Benefit Solutions claims processing and adjudication practices is preferred.
• Strong analytical and problem-solving abilities with a customer-focused mindset.
• Ability to identify discrepancies, errors, and process improvement opportunities.

Responsibilities

• Perform quality reviews and audits of claims to confirm accurate processing and policy application.
• Examine claim files to ensure documentation, eligibility, benefits, and payments are correct.
• Identify processing errors, trends, and workflow gaps and recommend improvements.
• Document audit results and communicate findings and corrective actions.

Skills

Claims adjudication

Attention to detail

Analytical skills

Customer-focused communication

Job description

Claims Examiner / Customer Benefits Payment Representative

Location: St. Paul, MN

Work Arrangement: Hybrid - 1 mandatory day onsite in St. Paul, 4 days remote

Schedule: Monday-Friday | 8:00 AM-4:45 PM | 45-minute unpaid lunch

Employment Type: Contract

Compensation: $28-$32/hour, depending on experience

Position Overview

Beacon Hill's client is seeking a detail-oriented Claims Examiner / Customer Benefits Payment Representative to support the accurate and timely review, processing, and payment of customer benefit claims. This position is ideal for someone with claims adjudication experience who combines strong analytical skills with a customer-focused mindset.The role will focus heavily on reviewing claim files for accuracy and completeness, identifying potential errors or process gaps, completing corrective actions, and ensuring claims are handled consistently with applicable policy provisions and service expectations.

Responsibilities

• Perform quality reviews and audits of Accident, Critical Illness, and Hospital Indemnity claims to confirm accurate processing and consistent application of policy provisions.
• Examine claim files to ensure required documentation has been collected, eligibility criteria have been satisfied, appropriate benefits have been identified, and payments have been processed correctly.
• Recognize claim-processing errors, recurring trends, workflow gaps, and opportunities to strengthen operational processes.
• Clearly document audit results and communicate findings, recommendations, and necessary corrective measures to appropriate partners.
• Make corrections to claim files when needed, including gathering additional information, revising claim determinations, issuing benefits, and resolving payment discrepancies.
• Support timely and accurate benefit payments through claim processing, data entry, record maintenance, fraud prevention, and eligibility or loss investigations.
• Provide professional, customer-focused communication to internal teams, clients, customers, and external partners.
• Maintain complete and accurate claim documentation to support quality standards, regulatory requirements, customer service, and potential litigation needs.
• Apply sound judgment and risk assessment when reviewing claims and determining appropriate next steps.
• Use available resources and strong problem-solving skills to investigate claims and reach well-supported conclusions.
• Review files for completeness and verify that all required information and supporting documentation are accurate.
• Contribute to special projects, process enhancements, quality initiatives, and other operational improvement efforts.
• Effectively manage an assigned workload while meeting established service levels and turnaround expectations.
• Assist with incoming department calls and respond to questions regarding claim status, policy provisions, and benefit determinations.

Qualifications

• Previous knowledge of or experience with Employee Benefit Solutions claims processing and claim adjudication practices.
• Excellent attention to detail with the ability to identify discrepancies, errors, and areas for improvement.
• Strong analytical, critical-thinking, and problem-solving abilities.
• Sound judgment and confidence making decisions based on available claim information.
• Strong written and verbal communication skills.
• Effective organizational and workload-management abilities.
• Positive, compassionate, and customer-focused approach.
• Ability to successfully meet expectations while working independently as well as collaboratively within a team.
• Comfortable learning and adapting to new technologies, systems, and changing processes.
• Strong commitment to providing a high-quality customer experience.

Equal Opportunity & Diversity

Beacon Hill is an equal opportunity employer and individuals with disabilities and/or protected veterans are encouraged to apply.

California residents: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

Company Profile

Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, a commitment to project completion and success and a passion for innovation, creativity and continuous improvement. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs.

Learn more about Beacon Hill and our specialty divisions, Beacon Hill Associates, Beacon Hill Financial, Beacon Hill HR, Beacon Hill Legal, Beacon Hill Life Sciences and Beacon Hill Technologies by visiting www.bhsg.com .

Benefits Information

• Beacon Hill offers a robust benefit package including, but not limited to, medical, dental, vision, and federal and state leave programs as required by applicable agency regulations to those that meet eligibility.
• Upon successfully being hired, details will be provided related to our benefit offerings.

We look forward to working with you!Beacon Hill. Employing the Future (TM)