Specialist Claims Processor

Our vision for the future is based on the idea that transforming financial lives starts by giving our people the freedom to transform their own. We have a flexible work environment, and fluid career paths. We not only encourage but celebrate internal mobility. We also recognize the importance of purpose, well-being, and work-life balance. Within Empower and our communities, we work hard to create a welcoming and inclusive environment, and our associates dedicate thousands of hours to volunteering for causes that matter most to them.

Chart your own path and grow your career while helping more customers achieve financial freedom. Empower Yourself.

Reporting to a Team Performance Leader, the Claims Processor is responsible for reviewing and entering health and dental benefit claim forms and receipts that have been submitted by our plan members.

What you will do

• This position is responsible for data entering all of the Medical, Dental, Hospital, Drug and Visions claims that are received each day for the Group Benefit Payment Offices and is performed independently. Modification of or deviation from procedures and practices is occasionally required. In this position, the entire claim submission must be reviewed quickly along with all attachments to enter information into an average between 75-150 fields per claim submission.
• The information must be entered extremely accurately and efficiently as there are very aggressive quality requirements and productivity target that must be obtained to meet the minimum requirements of the role. For a high percentage of claims, the Claim Processor will be the only person to see the claim submission. If the claim does not automate in the system, a Claims Examiner will use only the information the Claim Processor data entered onto the data entry system for final review/adjudication/payment of the claim. If errors are made in keying or by not following/interpreting the guideline information provided, the claims could be paid incorrectly resulting in overpayment or underpayment to the customers. As a result of services provided or actions taken, this could/would have a considerable impact on external client relations and the company.
• 80% Data entry, 20% misc. other duties
• Work independently to data enter a variety of health, dental, drug, hospital, and vision claims
• Review claim attachments and determine which data from this information is applicable
• Review complex claims with your team assistant and flag claims requiring further investigation
• Adhere to the changing requirements of our Health & Dental Claims policy job aids

What you will bring

• Excellent keyboarding skills (Mandatory)
• Good reading comprehension
• Basic PC computer & Microsoft Office skills
• College Degree is a must
• Ability to excel within a Purpose/Vision driven environment
• More than 6 months and up to and including one year experience required

This job description is not intended to be an exhaustive list of all duties, responsibilities and qualifications of the job. The employer has the right to revise this job description at any time. You will be evaluated in part based on your performance of the responsibilities and/or tasks listed in this job description. You may be required perform other duties that are not included on this job description. The job description is not a contract for employment, and either you or the employer may terminate employment at any time, for any reason, as per terms and conditions of your employment contract.

We are an equal opportunity employer with a commitment to diversity. All individuals, regardless of personal characteristics, are encouraged to apply. All qualified applicants will receive consideration for employment without regard to age, race, color, national origin, ancestry, sex, sexual orientation, gender, gender identity, gender expression, marital status, pregnancy, religion, physical or mental disability, military or veteran status, genetic information, or any other status protected by applicable state or local law.

Disclaimer: This job description has been sourced from a public domain and may have been modified by Naukri.com to improve clarity for our users. We encourage job seekers to verify all details directly with the employer via their official channels before applying.