Medical Claims Examiner

2 weeks ago


Oklahoma City, United States The Kempton Group Full time
Job DescriptionJob Description

 

Medical Claims Examiner

At The Kempton Group, we are changing the healthcare industry. We believe in transparency and we have the genuine desire to transform how employers and participants view and purchase healthcare. Kempton clients offer top-tier benefits where medical services are FREE to their employees and we have saved our clients over $100 Million in claims cost since launching the Kempton Premier Provider Program 10 years ago. The Medical Claims Examiner will be expected build and modify benefit plans in the claims adjudication system in an accurate & timely manner.

Other qualities & responsibilities include:

  • Excellent written and verbal communication skills
  • Review benefits of prior plans for new clients
  • Present benefit recommendations for plan renewals
  • Audit test claims
  • Run & analyze reports related to accumulators, claims paid, coverage records, etc.
  • Create plan documents such as: Summary Plan Description (SPD), Account Benefits Structure (ABS), Summary of Benefits and Coverage (SBC), Schedule of Benefits (SOB), etc.
  • Configure benefits to ancillary systems: IVR, member portal, provider portal, etc.
  • Conduct quality control procedures

 

Apply now

 

If you would like more information about the available position, please visit www.kemptongroup.com. We look forward to hearing from you

 

Company DescriptionFor 50 years, The Kempton Group Administrators, Inc. (KGA) has empowered self-funded employers to take control of their benefit plans. We encourage transparency and free market principles in every layer of healthcare. We do not promote gimmicks; we FIX your plan. Let us show you why an independent Third Party Administrator (TPA) is the right choice.Company DescriptionFor 50 years, The Kempton Group Administrators, Inc. (KGA) has empowered self-funded employers to take control of their benefit plans. We encourage transparency and free market principles in every layer of healthcare. We do not promote gimmicks; we FIX your plan. Let us show you why an independent Third Party Administrator (TPA) is the right choice.

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