Lead Claims Operator

Benecard Services Inc.•Clifton, NJ

6d•$22 - $23•Onsite

About The Position

The Lead Claims Operator will monitor daily claims and workload balancing, perform quality control reviews and error corrections, assist with batching, corrections, reversals and escalations, keying medical optometry and complex claims. This is a Union position, the salary will start at $22.38/hour and increase to $23.07/hour after 90 days of continuous satisfactory work. Required to be in offer 5 days a week in the Clifton, New Jersey location.

Requirements

High School diploma or equivalent is required
3-5 years of proven insurance claims experience is required
Must be proficient in computer skills, Microsoft office and Adobe.
Must have advanced knowledge of Excel to be successful
Ability to maintain a high level of accuracy and attention to detail in claims processing and data entry
Strong analytical and problem-solving skills
Strong communication and leadership skills
Professional verbal and written communication skills
Must be dependable and have good attendance history

Nice To Haves

Familiarity with the AS400 is a plus

Responsibilities

Coordinate and assign daily workflow to ensure timely and accurate claims
Perform duties such as electronically saving batches, responding to emails, and viewing plan sheets to ensure accurate payments
Review data for deficiencies or errors, correcting errors and conducting weekly quality assurance on direct member reimbursement claims
Monitor productivity, turn times, audit results and accurate metrics
Maintain 99.9% accuracy rate on claims, adjustments and corrections.
Present and conduct routine and targeted audit review of claims.
Analyze audit findings, identify error trends, and implement corrective action plans.
Assist with batching, claim corrections, reversals, medical optometry claims and claim reprocessing projects.