Job Description

The Company

With offices in San Francisco, California, this private equity sponsored organization is the largest and fastest-growing Third Party Administrator (TPA) in the United States. With over a half Century of benefit plan administration experience, 1,500+ team members, and 45 locations across the United States, this organization provides the technologies, services, systems, and support methodology to self-funded benefit plans to help meet the demands of increasingly complex and rapidly evolving regulatory changes in a cost-effective manner.

The Position (Temp-to-Hire)

Hours: 40 per week

The Claims Processor processes routine medical, dental and/or hospital claims and provides customer service, including providing information to hospitals, physicians and participants regarding eligibility, benefits and claims status with routine supervision.

Key responsibilities:  

 
  • Process routine medical, dental and/or hospital claims in accordance with assigned Plan(s).
  • Provide customer service by responding to and documenting telephone and/or written inquiries.
  • Consistently meet established performance standards, including quantity and quality claims processing standards.
  • Maintain current knowledge of assigned Plan(s) and effectively apply knowledge in the payment of claims, customer service, and all other job functions.
  • Provide back-up on other accounts as necessary.
  • Consistently demonstrate excellent attendance and punctuality.
  • Perform other related duties as assigned.


The Successful Candidate

The successful candidate will demonstrate the knowledge, skills, and abilities necessary to perform the essential functions of this position in a fast-paced, high-accountability environment. This includes, but is not limited to the following competencies:
  • Minimum of 6 months experience processing all types of group medical, dental and/or hospital claims; basic knowledge of benefits claims adjudication principles and procedures, medical and/or dental terminology and ICD-9 and CPT-4 codes.
  • High school diploma or equivalent.
  • Possess a strong work ethic and team player mentality.
  • Highly developed sense of integrity and commitment to customer satisfaction.
  • Ability to communicate clearly and professionally, both verbally and in writing.
  • Solid organization skills with strong detail orientation and listening skills.
  • Strong decision making, research and analytical abilities.
  • Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.
  • Ability to calculate figures and amounts such as discounts, interest, proportions, and percentages.
  • Ability to type 35 WPM; proficient PC skills, including MS Word and Excel.
  • Able to maintain excellent attendance and punctuality.
  • Must be able to work in environment with shifting priorities and to handle a wide variety of activities and confidential matters with discretion.
  • Inspires trust and open communication.
  • Self-motivated and self-starting personality.

Compensation 

The Claims Processor will be a skilled member of the Claims Department. As such, they will receive a competitive compensation package, to include:
  • Competitive compensation.
  • Health benefits.
  • Retirement plan. 
  • Opportunity for growth within the Nation’s largest and fastest-growing TPA!

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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