Claims Examiner/Member Services Representative

United Employers Association and its Affiliates; Portland (OR); Hybrid; USD 52,000 - 72,000; Full time

Job summary

Small Health and Welfare Claims Administrator is seeking a full-time Claims Examiner/Member Services Representative to process claims and provide outstanding service to clients. Training is in-office with a shift to hybrid work after completion.

The role demands attention to detail, excellent interpersonal skills, and a strong commitment to learning and helping others. Responsibilities include processing medical, dental, and vision claims, responding to requests via multiple channels, and

Qualifications

• Two years of claims experience in a healthcare environment.
• Excellent written and verbal communication skills.
• Knowledge of medical terminology, billing, and coding (IDC-10, CPT).
• Detail oriented with strong analytical and mathematical inclinations.

Responsibilities

• Process medical, dental, and vision claims with speed and accuracy.
• Respond to member and provider requests via phone, email, and in-person.
• Assess and resolve problems within authority, escalate complex issues to senior staff.
• Document all customer contacts clearly and thoroughly.
• Support other examiners and administrative staff as needed.

Skills

Communication

Attention to detail

Time management

Customer service

Interpersonal skills

Education

HS Diploma

College degree preferred

Tools

Microsoft Office

Job description

Small Health and Welfare Claims Administrator seeks full-time Claims Examiner/Member Services Representative to process claims and provide outstanding customer service to external and internal clients. This is a full-time, in-office position during the initial training period converting to hybrid work after the training period is completed.

Successful candidate must be detail oriented, possess excellent interpersonal skills, be a master communicator, and demonstrate a strong desire to assist others and continuously learn.

If you value . . .

• Work/life balance
• Stability
• Collaborative decision-making
• Quirky, relaxed work environment

we want to talk to you.

DUTIES

• Process medical, dental, and vision claims with speed and accuracy
• Professionally respond to member and provider requests via telephone, email, and in-person
• Assess and resolve problems within the scope of authority, elevate complex problems to senior staff
• Employ clarity, efficiency and compassion when communicating with clients
• Clearly document all customer contacts
• Support other claims examiners and administrative team as needed

QUALIFICATIONS

• HS Diploma, college degree preferred
• Two years claims experience in a healthcare environment
• Customer service experience preferred
• Excellent written and verbal communication skills
• Knowledge of medical terminology, billing, and IDC-10 and CPT codes
• Keen attention to detail; analytically and mathematically inclined
• Proficiency in Microsoft Office suite
• Excellent time-management, problem-solving, and organizational skills
• Must be mature, reliable, have a stellar work ethic, and also possess enthusiasm, initiative, and curiosity
• Patience and sense of humor are equally essential