Payment Protection Claims Specialist

SWBC; United States; On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Competitive compensation

Work/Life balance

Recognition awards

Years of Service awards

Career growth opportunities

Mentor program

Continuing education

Healthcare options

401(k) retirement plans

Wellness program

Job summary

SWBC is seeking a detail-oriented analyst to determine coverage under Payment Protection, set up claims, and process payments for claimants. You will assist Claims Examiners, manage claim files, and ensure accurate carrier reporting while handling inquiries from claimants and financial institutions.

The role involves testing ACH payment setups, creating letters, and training new staff as needed. Strong communication and Excel/Word skills are essential for success in a fast-paced team.

Qualifications

• High School Diploma or equivalency.
• Some college coursework in medical terminology or related field preferred.
• At least two (2) year analytical type general office or related experience.
• Strong analytical, organizational, and detail-oriented skills.
• Excellent verbal and written communication skills to interact with internal/external contacts and customers.
• Able to use basic office equipment and have excellent organizational and communication skills.
• Working knowledge of Microsoft Word and Excel.
• Strong analytical, organizational, and detail-oriented skills.
• Able to type 40 WPM accurately and know 10 key by touch.
• Able to move up to 20 lbs. of files and documents.
• Able to bend, stoop, and stand to perform filing duties.

Responsibilities

• Receives new and continuing claims submitted, determines coverage under Payment Protection, sets them up in the systems, and prepares/disburses the claim files to the Examiners.
• Creates claim payments in the system, enters claim notes in the systems, maintains carrier transaction reports, and balances such for each carrier to ensure accuracy with the issuance of payments.
• Takes incoming phone calls to assists claimants, financial institutions, and carriers to include documenting such within claim files and in the claims system.
• Requests missing information to establish new claims from the claimants and financial institutions.
• Creates new template letters and makes changes to existing.
• Tests new account setups for ACH claim payment process and/or updates to live systems environments.
• Trains new Payment Protection Processor I as needed.

Skills

Analytical

Organizational skills

Detail-oriented

Verbal and written communication

Typing 40 WPM

10-key by touch

Microsoft Word

Microsoft Excel

Education

High School Diploma or equivalency

Some college coursework in medical terminology

Tools

Microsoft Word

Microsoft Excel

Job description

SWBC is seeking a detail-oriented analyst to determine coverage under Payment Protection, set up claims, and process payments for claimants. You will assist Claims Examiners, manage claim files, and ensure accurate carrier reporting while handling inquiries from claimants and financial institutions.

The role involves testing ACH payment setups, creating letters, and training new staff as needed. Strong communication and Excel/Word skills are essential for success in a fast-paced team.