Reports to: Claim Team Lead/Supervisor of Claims Operation
FSLA Status: Non-Exempt
PHI Access: Yes
Department: Claims Administration
Prepared by/Date: careers.t7@90degreebenefits.com 03/15/23
Summary: Maintain claims inventory goals by accurately processing claims for assigned workload
Essential Duties and Responsibilities:
. Processing all claim types for assigned workload, maintaining a 10 day or less turnaround time. Interpret and understand Plan Document provisions. Work priority queue and various other claim queues within the priority queue. Maintain claims email mailbox, supporting Customer Service and Account Executives. Maintain void and refund process. Maintain HPS process. Maintain Zelis process. Handle subrogation cases. Regular and reliable attendance
Other Duties and Responsibilities
. Keep supervisor informed of known actions, written or verbal, which may affect the ability to successfully perform
assignments or adversely affect 90 Degree Benefits operations.
. Complete projects or other duties assigned by Supervisor.
Core Competencies
- Represent 90 Degree Benefits Core values, Mission and Culture
- Lead by example
- Be professional, courteous, and respectful of others
- Empower and develop others
- Communicate clearly and accurately, both written and orally
- Expand general knowledge of employee benefits
- Elevate performance by setting clear goals and expectations
- Foster knowledge, innovation, and productivity
- Work in a collaborative team environment
- Deliver the highest level of excellence
- Technical: To perform this job successfully the employee is proficient in working with the following systems:
- QicLink System
- VBA System
- Excel
- Word