Benefit Administration Services, Ltd.
  • Ridgeland, MS, USA
  • Full Time

Claims Adjudicator
 
Major Responsibilities
 
Responsible for processing claims for multiple groups for medical, dental, and vision benefits. Communicates with plan sponsors regarding claims as well as the employees or providers on questions that may arise.
 
 
Role Responsibilities
 
  • Processes medical, dental, and vision benefits for multiple groups.
  • Sends claims for repricing as needed.
  • Answers questions regarding coverage and claims procedures for group sponsors, clients, employees, and providers. Provide forms and other claims related materials upon request to clients/employees. 
  • Assist in various claims research requests to assist in developing and preparing reports, letters and spreadsheets.
  • Processes the check runs for groups and submits files electronically to our print vendor. 
  • Handles check releases for all groups through our print vendor's website as well as folding and mailing out EOBs for providers.
 
 
Professional Qualifications
 
Knowledge - level of education required, special certifications or licenses
 
  • High School Diploma or Equivalent.
 
Skills - job-specific knowledge and abilities, general business acumen, other required skills
 
  • Basic knowledge of relevant laws and regulations applicable to benefit plans, COBRA, HIPAA, and the Affordable Care Act.
  • Strong analytical abilities and critical thinking capabilities
  • Must have "Team Player" mentality
 
Experience - level or related/unrelated work experience, number of years in prior jobs
 
  • Two (2) years of benefits, insurance, medical coding experience.
 
Technical Competencies - technical or other skills such as position specific software
 
  • Proficient in Microsoft Office software.
 
Professional Competencies - leadership, team building, training, financial skills
 
  • Customer Focus
  • Communicate Effectively
Benefit Administration Services, Ltd.
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