Healthcare Claims Refund Specialist
About The Position
Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Claims Refund Specialist, you’ll play an important role in helping us offer customized, self-funded insurance options to our clients and members. The Claims Refund Specialist is responsible for various administrative tasks related to services and claims for our health plans, such as addressing queue claims, reviewing summary plan documents, processing refunds and overpayments, documentation, and reporting. At Cobalt Benefits Group, we operate on a member first approach, always providing the best service possible to our members and partners. The ideal candidate is detail-oriented, with exceptional communication skills, and a background in healthcare/insurance processing.
Requirements
- 6 months’ experience in healthcare or insurance industry with respect to operations support, including provider maintenance, billing, coding, or customer support.
- Experience in health care billing or a background with a health insurance carrier or Third-Party Administrator strongly desired.
- Solid time-management skills, with the ability to prioritize multiple tasks, while working with a sense of urgency.
- Strong interpersonal skills with excellent verbal and written communication skills.
- Basic keyboard and Windows based computer skills required.
- Familiarity with Microsoft Excel.
- Eager to learn the TPA industry and new concepts and processes.
Responsibilities
- Audit, review, and adjust medical, dental, and flexible spending accounts and Health Reimbursement Account claims.
- Review, apply and create refund letters for all lines of business to members and providers.
- Reprocess payments when necessary.
- Communicate with members, providers, employer group contacts, and other inquirers pertaining to specific refund questions.
- Review plan documents for various groups to research and resolve claim processing questions and issues.
- Act with urgency to respond to inquiries regarding refund request status-including research and resolution regarding outstanding request.
- Perform other related duties, as assigned.
Benefits
- Fantastic medical, dental, and vision insurance
- Twice annual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible!
- Company provided Basic Life and AD&D
- Company paid Short-Term and Long-Term Disability
- Flexible Spending Accounts
- 401(k) Retirement Plan with up to a 6% employer-match WOW! (100% fully vested after 3 years)
- 10+ paid holidays
- Half-day Summer Fridays
- Generous paid vacation and sick time
- Annual Volunteer Paid Day
- Annual Tuition Reimbursement
- Annual Health and Wellness Reimbursement
- Lots of fun company events
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
