Benefits Claims Auditor

Company: EBPA
Location: South Burlington
Posted on: March 21, 2023

Job Description:

Job Description:

Job Description Role Summary: The ideal candidate is detail oriented with exceptional communication skills and a background in health care/insurance processing. Further knowledge of flexible spending accounts and COBRA products is a plus. Our Claims Auditors report to the Claims Manager and have a knack for problem solving and enjoy collaborating with internal resources to provide exceptional service to members and clients. Responsibilities:Ensure accuracy of claims processing while maintaining quality and turn around goalsAudit, review, and re-work medical, dental, tuition, and flexible spending account and Health Reimbursement Account claimsProcess complex and high-dollar health insurance claimsCommunicate with members, providers, employer group contacts and other callers pertaining to specific benefit questionsReview plan documents for various groups to research and resolve medical, dental and vision service processing issuesAct with urgency to respond to inquiries regarding benefit claim status-including research and resolution regarding claims denial for all product offeringsProvide high level interpretations to clients regarding flexible spending accounts including unreimbursed medical accounts, dependent care, and tuition, parking and transit products.Associates Degree or 5+ years of health care or related experienceExperience in health care billing or a background with a health insurance carrier or Third-Party Administrator strongly desiredWorking knowledge of Microsoft Office and OutlookDemonstrated Customer Service expertise, including both internal and external customers PI208374949

Keywords: EBPA, New England , Benefits Claims Auditor, Accounting, Auditing , South Burlington, Northeast