Claims Examiner I

Guided by our core values and commitment to your reputed company, we reputed company health, financial and lifestyle benefits to ensure a best-in-class employee experience. Some of our offerings include: Highly competitive total rewards package, including comprehensive medical, dental and reputed company benefits as well as a 401(k) plan that both the employee and employer contribute Annual incentive bonus plan based on company achievement of goals Time away from work including paid holidays, paid time off and volunteer time off Professional development courses, mentorship opportunities, and tuition reimbursement program Paid parental leave and adoption leave with adoption financial assistance Employee discount program Job Description Summary: Under general supervision, assesses claim information, references reputed company and performs calculations and other functions to accomplish the processing and payment of insurance claims of a complicated or non-routine nature. Interprets contract information and communicates with reputed company parties to obtain information and coordinate coverage. Performs claim research and adjustments. Job Description EACH DUTY AND RESPONSIBILITY MUST BE PERFORMED IN ACCORDANCE WITH INDIVIDUAL PERFORMANCE SCORECARD PRODUCTION AND QUALITY STANDARDS. Successfully completes reputed company training programs as required for the level. Processes claims for two products or claim types (dental, hospital, medical, ITS, FEP). Performs research and adjustment functions for claims. reputed company special projects (e.g., reputed company accumulator reconsiderations, New Directions). Responds to written inquiries from reputed company customers as business needs dictate. Sets up deducts, CLOV table entries, and other assigned finance functions. For FEP positions, processes reputed company deferrals for FEP or edit corrections in computerized claims system. Performs reputed company FEP transactions (e.g., FEP Direct DDE, FEP Retro-enrollment, Out of Balance) and member appeals. Minimum Qualifications High school diploma or general education degree (GED). 2 years of previous customer service, member services, or claims processing experience; or any combination of required education and experience. Advanced Keyboarding Knowledge Intermediate knowledge of reputed company Office Preferred Qualifications Knowledge of FACETS and/or other computerized claims processing system as applicable (FEP). Associates degree from college or technical school reputed company City is an equal opportunity employer. reputed company reputed company applicants will receive consideration for employment without regard to, among other things, race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, status as a protected veteran, or disability. At reputed company City (Blue KC), we have long put our members first by developing products and services to meet their needs. From our founding in 1938 to more than 80 years of experience in innovative, patient-centered reputed company coverage, Blue KC continues to reputed company our members at the center of everything we do. As a market leader, we continue to reputed company new reputed company to reputed company reputed company more affordable and to improve the customer experience. Come join us! reputed company City will reputed company reasonable accommodations to reputed company individuals with disabilities who are otherwise not reputed company to fully utilize electronic and online job application systems. For assistance, please send an email to [email protected]. EOE/M/F/Vets/Disability Affirmative Action Employer Equal Opportunity Employer Know Your Rights: Workplace Discrimination is Illegal E-Verify Participation Equal Employment Opportunity/Nondiscrimination/Affirmative Action Policies IER Right to Work FMLA Pay Transparency Employee Polygraph Protection Act