Medical Claims Processor

Position Summary: We are seeking a detail-oriented and dependable Medical Claims Adjuster / Claims Specialist to join our team. This role involves reviewing, processing, and entering a variety of claims including medical, optical, dental, and Health Reimbursement Arrangement (HRA) reimbursement claims. You will also be responsible for providing accurate coverage information to union members and ensuring confidentiality of all personal health information.

Key Responsibilities:

• Accurately review and process Medical, Optical, Dental, and HRA reimbursement claims
• Enter claims data into the system in a timely and efficient manner
• Provide clear and accurate coverage information to union members and their dependents
• Handle sensitive medical information with strict confidentiality and in accordance with HIPAA guidelines
• Resolve issues and discrepancies in claims with a strong problem-solving approach
• Multitask effectively in a fast-paced environment while maintaining high attention to detail

Qualifications:

• Previous experience in claims processing, healthcare administration, or a similar role preferred
• Familiarity with healthcare benefits, reimbursement policies, and HIPAA compliance
• Strong problem-solving skills and attention to detail
• Excellent communication and customer service skills
• Ability to multitask, prioritize workload, and meet deadlines
• High level of discretion in handling confidential information

Employee Benefits Overview

• Paid Holidays : The office observes 13 paid holidays each calendar year.
• Vacation and Sick/Personal Leave : Employees become eligible for 10 vacation days and 5 sick/personal days annually upon completion of a six-month probationary period as a full-time employee. Vacation entitlement increases after three full calendar years of continuous employment.
• Retirement Contributions : A contribution equivalent to 10% of the employee's salary, up to the maximum allowed by the IRS, will be made on their behalf to an annuity fund.
• Health Benefits : Comprehensive medical, dental, and vision insurance coverage is provided. Detailed information is available in the Summary Plan Description. Coverage begins after three months of employment.
• Health Reimbursement Arrangement (HRA) : An HRA is available to assist with eligible out-of-pocket medical expenses.
• Pension Plan : Contributions are made on the employee's behalf to the Central Pension Fund. Pension benefits are available upon meeting the required years of credited service.

Job Type: Full-time

Pay: $60,000.00 - $65,000.00 per year

Schedule:

• 8 hour shift

Work Location: In person