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Open nowPosted 7 hours ago

Claims Coordinator

Workable (global search)107,801 open roles

Where
United States
Work mode
Remote
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Your applicationOpen nowClaims CoordinatorWorkable (global search) · United States

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The clock on this job

Early applications get read.

8.0% of postings close within 7 days. Measured by our own scanner across the market. Workable (global search) postings stay open a median of 2 days.

Share of postings closed within
  1. 1.6%1 day
  2. 3.5%3 days
  3. 8.0%7 days
  4. 14.9%14 days
  5. 34.1%30 days
This job: posted 7 hours ago

Workable (global search) median: 2 days open

The posting

Position Summary:

The Claims Coordinator represents the organization in a professional manner and interacts effectively with diverse stakeholders to deliver outstanding service. This role maintains day-to-day internal claims processing operations and collaborates closely with client-facing teams and outsource partners to enhance claims efficiency, accuracy, and operational capacity. The Claims Coordinator works under general supervision to ensure compliance with service level agreements (SLAs).

Principal Duties & Responsibilities:

  • Claims Processing & Operations:
  • Monitor and respond to specified Jira ticketing queues in the Jira Claims project. (Intermediate)
  • Act as an operational resource regarding claims services and procedures, responding to daily inquiries and specific claim questions from outsource partner(s) via the Jitbit claims processing system. (Intermediate)
  • Assist outsource partners and Account Management teams with reporting requests. (Intermediate)
  • Review and process Letters of Medical Necessity and Prescriptions submitted by account participants in accordance with IRS guidelines. (Beginner)
  • Process Improvement & Quality Assurance:
  • Identify potential processing bottlenecks, system issues, and opportunities for workflow enhancements. (Intermediate)
  • Monitor and analyze consistent errors or recurring questions from outsource partners and internal staff. (Intermediate)
  • Collaborate with the Claims Department Supervisor to refine training materials, update processor documentation, and share best practices to minimize recurring error rates. (Advanced)
  • Perform ad hoc projects and additional responsibilities as assigned by department leadership. (Beginner)

Requirements

Knowledge, Skills, and Abilities Required:

  • Claims Processing & Technical Skills:
  • Claims & TPA Knowledge: Working knowledge of third-party administration (TPA), consumer-directed health benefits, and claims adjudication processes. (Intermediate)
  • Technical Proficiency: Proficiency in Microsoft Office/Google Workspace and experience navigating Jira and Jitbit. (Intermediate)
  • Claims Knowledge: Proficiency in claims processing workflows, manual adjudication, and appeals. (Intermediate)
  • Software Capability: Aptitude for mastering and using proprietary claims processing systems.(Intermediate)
  • Analytical Proficiency: Ability to analyze complex data, identify discrepancies, and accurately calculate and process adjustments in the claims system. (Intermediate)
  • Data Analysis & Problem Solving: Demonstrated capability to evaluate complex data, identify discrepancies, and accurately calculate adjustments. (Intermediate)
  • Regulatory Knowledge: Knowledge of consumer-directed health benefits regulations and all relevant HHS standards for the secure handling of Protected Health Information (PHI). (Intermediate)
  • Technical Skills: Proficiency in Microsoft Office/Google Workspace and experience navigating Jira and Jitbit. (Intermediate)
  • Communication & Discretion: Excellent written, verbal, and interpersonal communication skills to explain complex issues to various stakeholders; strong email etiquette and proven ability to handle confidential information with tact and discretion. (Intermediate)

Credentials & Experience:

  • Education & Experience:
  • Graduation from an accredited college, university, or technical school is required.
  • Background or experience in Benefits Administration.
  • Prior experience in claims processing, TPA operations, or customer service is preferred.

Benefits

BENEFITS

  • Medical Insurance
  • Vision Insurance
  • Dental Insurance
  • 401(k) Matching
  • Flexible Spending Accounts
  • Health Savings Accounts
  • Disability & Life Insurance
  • Employee Assistance Program
  • LegalShield
  • ID Shield
  • Commuter Reimbursement Plan
  • Tuition Reimbursement
  • Bonus Pay

ADDITIONAL BENEFITS INCLUDE:

  • Wellable membership
  • Telescope Health (telehealth) through Accresa
  • Intellect (mental health) application
  • Employee engagement activities, including voluntary events, raffles, book club, and more!

PHYSICAL DEMANDS AND WORKING CONDITIONS:

Work in an office environment; sustain posture in a seated position for prolonged periods of

time; use hands to grasp and reach; occasionally stoop or kneel; see, hear, and speak with

sufficient acuity to successfully perform all aspects of the job; use telephone and write or use a

keyboard to communicate through written means; lift up to ten pounds of weight.

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