Specialist, Claims and Adjustments - FEP

Blue Cross & Blue Shield of Mississippi • Flowood, MS

5d

About The Position

The FEP Claims and Adjustment Specialist is responsible for maintaining inventories which focus on the accurate and timely processing of member claims and benefit plan updates. The FEP Claims and Adjustment Specialist will process claims in both the NAS (internal system) and FEP Direct (external system). In addition, the FEP Claims and Adjustment Specialist is responsible for reviewing and taking action on communication received from providers and members via written communication and inquiries received from Customer Service Support.

Requirements

• Bachelor’s degree required.
• Average PC skills including experience with Microsoft Office suite.
• Logical thought process in order to interpret and apply contract benefits as well as identify issues, recommend solutions, interpret and apply contract benefits and accurately adjust claims.
• Customer focused and service oriented to ensure timely and accurate performance and benchmark achievement.
• Ability to work with a high degree of accuracy and attention to detail to ensure work products are of high quality.

Responsibilities

• Process claims in both the NAS (internal system) and FEP Direct (external system).
• Review and take action on communication received from providers and members via written communication.
• Respond to inquiries received from Customer Service Support.

Benefits

• Comprehensive benefits package that is worth approximately one-third of the salary compensation.
• Benefits program is among the best in the health care field.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level