Department Benefits
Category Benefits
City Oklahoma City
State OK
Travel
Involved
0-10%
Type of
Position
Full-Time

Rep, Benefit Adjuster I

AFA / Worksite

Description:

*Evaluates and processes claims that require routine judgement and investigation such as Diagnostic Testing, Wellness, Physician Expense, URM, GAP, Medlink, Dental, Triage/Incomplete or Pregnancy claims in accordance with Company policy terms, insurance laws, regulatory requirements and adjusting guidelines.

*Provides appropriate verbal and/or written communication to internal and external Customers in a positive and knowledgeable manner to ensure a high standard of Customer service. Meets standards established in department performance metrics for appropriate handling of Customer phone calls.

*Acts as a direct contact and communicates with Customers and medical providers in a positive, knowledgeable and professional manner, providing them with direction and assistance in all facets of insurance coverage and needs.

Requirements:

  • Six open positions 
  • Prompt and reliable
  • Good medical terminology preferred
  • Possesses General PC Windows-based software knowledge with the ability to learn new applications and work in a paperless environment
  • Good understanding of anatomy and physiology
  • Good contract knowledge
  • Familiarity with CPT and ICD10 coding
  • Possesses good analytical skills and judgment
  • Ability to be flexible in work schedule, including a willingness to work overtime as needed
  • Good oral and written communication skills
  • Ability to handle fast-paced environment
  • Professional attitude
  • Dedicated to providing world-class Customer service
  • Ability to work well within a team environment