Benefits Coordinator

3 days ago


Coral Gables, Florida, United States DOCTORS HEALTHCARE PLANS, INC. Full time
Job Summary

We are seeking a highly skilled Benefits Coordinator to join our team at Doctors Healthcare Plans, Inc. The ideal candidate will have excellent communication skills, a strong understanding of healthcare regulations, and the ability to work well under pressure.

Key Responsibilities
  • Claims Processing: Analyze, process, and research claims that involve other insurance carriers, ensuring timely and accurate processing.
  • COB Claims Management: Process and monitor COB claims according to CMS guidelines, investigating members for other insurance and communicating with providers and members as needed.
  • Quality Assurance: Maintain quality standards in all research and adjustment functions, ensuring accuracy and completeness of claims data.
  • Communication: Communicate effectively with other professional and support staff to achieve positive customer outcomes, promoting a positive and problem-solving environment.
  • Compliance: Ensure compliance with company policies and procedures, as well as federal, state, and local regulations, including HIPAA and OSHA.
Requirements
  • Education and Experience: 1-3 years of health claims processing experience, with a working knowledge of COB and MSP.
  • Skills and Qualifications: Excellent oral and written communication skills, strong organizational skills, and the ability to work well under pressure. Bilingual: English/Spanish (required).


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