Note: The essential duties and primary accountabilities below are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Candidates may perform all or most of the primary accountabilities listed below. Specific tasks, responsibilities, or competencies may be documented in the candidates performance objectives as outlined by the candidates immediate supervisor.
1. Review and process claims submitted by participants, ensuring all documentation is complete and accurate.
2. Process COBRA/Direct Bill request for service forms.
3. Verify eligibility of expenses according to IRS regulations and company policies.
4. Process reimbursements promptly and accurately to minimize delays for employees.
5. Respond to participant inquiries regarding claims, eligibility, and account balances via email and chat.
6. Provide clear and concise guidance to participants on claim submission procedures and regulations.
7. Maintain organized records of all claims processed, including documentation and communication.
8. Update and manage claims data in the companys claims management system.
9. Stay informed about changes in IRS regulations regarding Consumer Benefit accounts and ensure compliance in all claims processing activities.
10.
Assist in conducting audits and compliance reviews as needed.
11. Identify trends or potential issues in claims submissions and recommend improvements.
ESSENTIAL KNOWLEDGE, SKILLS & ABILITIES Education: High school diploma or equivalent; associate or bachelor’s degree preferred.
Work or Related Experience
- Previous experience in claims processing, customer service, or a related field is preferred.
- Strong attention to detail and organizational skills.
- Excellent written communication abilities.
- Proficiency in Microsoft Office Suite and experience with claims management systems is a plus.
- Ability to handle sensitive information with confidentiality and professionalism.
- Knowledge of the Consumer Perks industry and regulations preferred.
- Demonstrate a positive attitude and demonstration of flexibility in meeting client needs.
- Attention to detail and the ability to analyze and problem solve is essential. Ability to manage multiple tasks and responsibilities, and successfully work under time constraints.
- Ability to work in a team environment as well as independently.
- Detail-oriented with excellent analytical and investigative skills.
- Understanding of HIPAA and Privacy Regulations