Medical Claims Examiner/Eligibility Coordinator

Job Description

Job Description

Successful candidate will perform routine claims processing, process payments or rejections of benefits, answer incoming telephone calls and provide customer service to assist participants, calculate eligibility and coordination of benefits, request documents and other participant information as necessary, enter eligibility and dependent information in computer as required, and process voids, stop-payments, and refunds. Performs other duties as needed. Must have ability to learn claims processing software.

Successful candidate will perform eligibility calculations for health care benefits, monthly processing of self-payments, termination notices, COBRA notices, Qualified Medical Child Support Orders and death benefit claims processing. Runs reports, assists with mass mailings, and enters eligibility and dependent information in computer as required. Qualified candidate will also provide customer service via telephone and in person as needed. Performs other duties as needed.

Qualifications:

1. Graduation from high school or equivalent combination of training and experience with emphasis on CRT entry or keypunch experience, work processing and/or mathematics preferred.

2. Six months interoffice experience.

3. Must be conscientious, efficient and dependable.

4. Willingness and ability to meet deadlines on a daily, weekly and monthly basis.

5. Office skills including: data entry and calculator.

6. Ability to use office equipment including PC and systems, including Microsoft Office (including Word and Excel), copy machine, and fax.

7. Ability to establish and maintain effective working relationships.

8. Physical ability to: a) sit for long periods of time, b) bend stoop and stretch as required to operate file cabinet drawers, c) carry files, books and other types of office paperwork and, d) operate PC keyboard and other office equipment.

9. Ability to be bonded.

10. Ability to speak clearly to participants in English.

11. Ability to read and compose letters and other documents in English.

12. Ability to learn claims processing software.

Competitive Pay. Employer contributes to 401(k) with no employee match required. 100% employer paid Life, AD&D, STD and LTD benefits provided.

Equal Opportunity Employer

Company Description

TIC provides consulting and administration of plan design, funding, eligibility testing, claim adjudication, benefit payment, FASB ASC 965 (formerly SOP 92-6), COBRA, HIPAA, SPD's, QMCSO's or QDRO's will welcome the comprehensive service solutions available at TIC Midwest, LLC.

TIC is an independent full service company that specializes in the administration and communication of employee benefit plans.

TIC has been in business since 1951. We have clients throughout the Midwest that are served from three TIC office locations. From the beginning, we have offered services to the multiemployer benefit plan industry. Many of the multiemployer plans operating today were designed and established by us. We are familiar with the special challenges of Taft-Hartley plans and the collective bargaining process.

We are proud of the long-term relationship we have with our clients. We are also proud of our staff which includes administrators, consultants, computer specialists, and accountants - many with advanced degrees and certifications.

TIC is a long-time member of the International Foundation of Employee Benefit Plans and the Society of Professional Benefit Administrators. Our employees have, over the years, been directors and committee members of these organizations and have been speakers and authors for them on a wide range of employee benefit topics at educational seminars and programs they conduct around the country.

Equal Employment Opportunity (EEO) Employer

Company Description

TIC provides consulting and administration of plan design, funding, eligibility testing, claim adjudication, benefit payment, FASB ASC 965 (formerly SOP 92-6), COBRA, HIPAA, SPD's, QMCSO's or QDRO's will welcome the comprehensive service solutions available at TIC Midwest, LLC.\r\n\r\nTIC is an independent full service company that specializes in the administration and communication of employee benefit plans. \r\n\r\nTIC has been in business since 1951. We have clients throughout the Midwest that are served from three TIC office locations. From the beginning, we have offered services to the multiemployer benefit plan industry. Many of the multiemployer plans operating today were designed and established by us. We are familiar with the special challenges of Taft-Hartley plans and the collective bargaining process.\r\n\r\nWe are proud of the long-term relationship we have with our clients. We are also proud of our staff which includes administrators, consultants, computer specialists, and accountants - many with advanced degrees and certifications.\r\n\r\nTIC is a long-time member of the International Foundation of Employee Benefit Plans and the Society of Professional Benefit Administrators. Our employees have, over the years, been directors and committee members of these organizations and have been speakers and authors for them on a wide range of employee benefit topics at educational seminars and programs they conduct around the country.\r\n\r\nEqual Employment Opportunity (EEO) Employer