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Senior Claims Specialist

2 months ago

Philadelphia, Pennsylvania, United States Independence Blue Cross Full time
{"title": "Senior Claims Specialist", "description": "Job Summary

We are seeking a highly skilled Senior Claims Specialist to join our team at Independence Blue Cross. As a key member of our claims team, you will be responsible for accurately and timely handling claim issues for all lines of business, including bi-directional sharing, FEP, Local and Commercial PA and AHNJ, BlueCard and Government market.

Key Responsibilities
  • Apply and maintain comprehensive knowledge of claims processing and support systems.
  • Provide expertise and share knowledge to support other team members.
  • Research and adjust complex and/or high dollar adjustment requests received from all areas, inclusive of internal and external sources.
  • Handle FEP reconsiderations accurately and timely per the FEP benefit manuals and guidelines.
  • Meet departmental quality and production requirements.
  • Respond professionally to external/internal inquiries, as appropriate, while maintaining corporate and departmental standards.
Requirements
  • High School graduate or equivalent work experience.
  • 5 proven work experience in a production environment.
Preferred Qualifications
  • Demonstrated math and comprehension skills.
  • Good interpersonal skills for handling internal and external customers.
  • Well-developed listening, verbal and written communication skills.
  • Proficiency with Microsoft Office, specifically Excel and Word.
Work Environment

This role is designated as a role that fits into the "Hybrid" model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

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