Claims Processor - Hybrid FT

Are you passionate about making a difference in healthcare and insurance? Do you thrive in a fast-paced environment where your attention to detail and problem-solving skills are key? If so, we want to hear from you! About the Role: As a Claims Processor , you'll be at the heart of ensuring that submitted invoices are processed accurately and efficiently. Your mission will be to review, adjudicate, and manage claims with precision, while providing exceptional customer service. You'll work closely with our Care Coordination department to manage annual claims payments, ensuring everything is handled with the utmost accuracy and integrity. Key Responsibilities: Claim Analysis & Adjudication (80%): Scrutinize invoices to ensure they are complete and accurate. Collaborate with claimants, providers, and internal teams to resolve issues and make decisions based on established policies. Enter data meticulously into our claims processing systems. Communication & Correspondence (10%): Engage with internal teams and providers to clarify and resolve claim issues. Draft clear and professional communications to claimants. Assist in addressing customer complaints with empathy and efficiency. Risk Management (10%): Identify and investigate potential fraud or abuse. Report and track red flags to ensure compliance and proper adjudication. What We're Looking For: High School education required. Experience processing claims in a healthcare, disability, dental, or long term care environment required OR insurance operations experience, preferred Demonstrated computer proficiency which includes strong keyboard and navigation skills. Successful completion of new hire training and demonstrated proficiency required Required to uphold the principles of compliance and fraud management as outlined by corporate and departmental policies. Supports and participates in the mandatory training on an annual or more frequent basis, as required. Location: Portsmouth, NH - HYBRID 2 days in office Full-Time Position M-F with core business hours Why Join Us? Our mission is to grow and modernize insurance and benefits programs for federal agencies, military service organizations, insurers, and other select clients and partners by providing customized administrative services, well-designed and secure platforms, and an exceptional experience for customers. At FedPoint, we offer a dynamic work environment where innovation and collaboration are encouraged. You'll have the opportunity to make a significant impact while honing your administrative service skills and advancing your career. In addition to working for a company with great people and an excellent reputation, what's in it for you ? Generous 401k plan : 100% match of employee's contribution, up to a maximum of 6% salary, vests immediately. Lots of paid time off :3 weeks' vacation, 7 sick days, 3 personal days, and 12 paid holidays! Competitive benefits include health, dental, vision, disability, life, legal, flexible spending account (FSA) and Health Savings Account (HSA) options. 6 weeks fully-paid parental leave Tuition reimbursement program to support career goals. Corporate giving and matching gifts program. Volunteer program : Paid time off to volunteer and company-organized volunteering opportunities. A wide variety of personal, professional, and career development programs. Comprehensive wellness program offering a variety of resources and activities to help support your well-being in the following areas: career, financial, mental, emotional, physical, social and community. All offers of employment with FedPoint are conditional upon satisfactory completion of a pre-employment background check. FedPoint is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability. If you'd like to view a copy of the company's affirmative action plan, policy statement or have a disability and you believe you need a reasonable accommodation in order to search for a job opening or to submit an online application, please call (603). Equal Employment Opportunity Posters

Created: 2024-11-05