Benefits Claims Specialist

2 weeks ago


Cincinnati, Ohio, United States Western & Southern Life Full time
About Western & Southern Life

Welcome to Western & Southern Life, a company that has been creating value for our customers through everything we do for over 135 years. Our focus on building a strong culture that supports our associates is foundational to who we are.

We provide meaningful and challenging work for our professionals, which is a key facet of our incredible culture that helps make Western & Southern Life a career destination.

Job Summary

We are seeking a skilled Benefits Claims Processor to join our team. As a Benefits Claims Processor, you will be responsible for processing medical and flexible spending account claims in accordance with the provisions of multiple welfare plans administered by the Benefits Department.

This position involves approving claims involving payments up to $4,000 and utilizing the Claim Facts System and Flexible Spending Account System to accomplish functions. Claims experience and medical terminology experience are preferred.

Key Responsibilities
  • Coordinates claims with Medicare and other group insurance carriers.
  • Maintains a working knowledge of rules established by Medicare for coordination of benefits and rules established by the (NAIC) National Association of Insurance Commissioners for other group insurance.
  • Detects fraud or potential fraudulent claims.
  • Maintains a working knowledge of medical terminology to interpret medical reports and bills to properly adjudicate claims.
  • Keeps abreast of new medical procedures and terminology.
  • Determines proper payees for benefits in order to discharge Company's liabilities.
  • Maintains compliance with applicable federal and state laws (e.g., HIPAA).
What We Offer

We offer a comprehensive benefits package, including medical, dental, vision, prescription, pet insurance, life insurance, disability, Fertility, maternity/caregiver & parental leave, and more.

We also offer a retirement solution with our 401(k) savings AND pension plan, paid time off that increases with tenure, tuition reimbursement, subsidized affordable parking, on-site cafeteria and fitness center, on-site registered nurse, career coaching/mentoring, individualized development plans and career pathing.

Learn more about who we are and what we offer by visiting our website.



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