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Sedgwick
Milwaukee, WI | Full Time
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BeneSys, Inc.
Milwaukee, WI | Full Time
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Claims Examiner (Milwaukee, WI)
BeneSys, Inc. Milwaukee, WI
$60k-77k (estimate)
Full Time | Investment Management 3 Weeks Ago
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BeneSys, Inc. is Hiring a Claims Examiner (Milwaukee, WI) Near Milwaukee, WI

Claims Examiner (Milwaukee, WI)
Summary - Processes routine medical, dental, vision and HRA claims and provide customer service, including providing information to hospitals, physicians and participants regarding eligibility, benefits and claims status.
Essential Duties and Responsibilities include but not limited to
  • Process routine medical, dental, vision, HRA claims in accordance to plan benefits.
  • Provide customer service by responding to and documenting telephone and/or written inquiries.
  • Consistently meet established performance standards, including quantity and quality claims processing standards.
  • Maintain current knowledge of assigned Plan(s) and effectively apply knowledge in the payment of claims, customer service, and all other job functions.
  • Regular and predictable attendance is an essential function of this job.
Education and/or Experience
  • High School diploma or equivalent required.
  • Basic knowledge of benefits claims adjudication principles and procedures, medical and/or dental terminology and ICD-9 and CPT-4 codes.
Qualifications
  • Claims examiner experience, preferred.
  • Proficient with computers including keyboarding including 10-key (demonstrated ability to type quickly and accurately) and use of Microsoft Word, Outlook, and Excel.
  • Provide excellent verbal and written communication skills and be capable of responding to high quality customer inquiries.
  • Possess a strong work ethic and team player mentality.
  • Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.
  • Ability to calculate figures and amounts such as discounts, interest, proportions, and percentages.
  • Strong decision-making, problem-solving, organizational skills and able to work in a “team” environment.
Work Schedule - Full-time. Monday – Friday, 8:00am - 4:30pm. Requires in-office days with possibility of one work from home day per week after full training.
Competitive Benefits and Compensation Package
  • Paid Time Off (PTO)
    • Pro-rated during first year of employment
    • 15 days of PTO provided in the next calendar year!
  • 11 paid holidays
  • Health insurance, includes dependent coverage
  • Employer-paid term life insurance
  • Tuition reimbursement
  • Long term disability insurance
  • Career development opportunities
  • 401k with employer match
Pay
The pay range is $54,000 - $58,000 per year and is dependent on location, experience, skills, education and other business factors.
Our Culture
BeneSys wants to be a great service provider to the members we serve, and we recognize we can only do that if we are also a great employer with successful employees. In short, our success is driven by our employees’ successes. We want to be a place where people want to work, feel proud of what they do and feel fulfilled both professionally and personally. We want to create a place where employees can find long-term growth and potential.
Our culture focuses on three core values:
  • Collaboration: working together across 31 locations to achieve the best for the company and our clients
  • Dedication: striving to create an environment where all employees work toward a common goal while committing to providing the best customer service to our members and our colleagues
  • Integrity: doing what we say we will do. Upholding strong ethical and moral principles
ADA & EEO
Reasonable accommodations will be made so that qualified individuals with disabilities are able to complete the application process and, if hired, fulfill the essential functions of their job.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Investment Management

SALARY

$60k-77k (estimate)

POST DATE

04/06/2024

EXPIRATION DATE

06/05/2024

WEBSITE

benesysinc.com

HEADQUARTERS

TROY, MI

SIZE

100 - 200

FOUNDED

1979

TYPE

Private

REVENUE

$10M - $50M

INDUSTRY

Investment Management

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About BeneSys, Inc.

BeneSys provides administration and information technology services to trust funds.

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The job skills required for Claims Examiner (Milwaukee, WI) include Customer Service, Problem Solving, Written Communication, Decision Making, Claim Processing, Health Insurance, etc. Having related job skills and expertise will give you an advantage when applying to be a Claims Examiner (Milwaukee, WI). That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Claims Examiner (Milwaukee, WI). Select any job title you are interested in and start to search job requirements.

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The following is the career advancement route for Claims Examiner (Milwaukee, WI) positions, which can be used as a reference in future career path planning. As a Claims Examiner (Milwaukee, WI), it can be promoted into senior positions as a Claims Examiner III that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Claims Examiner (Milwaukee, WI). You can explore the career advancement for a Claims Examiner (Milwaukee, WI) below and select your interested title to get hiring information.

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If you are interested in becoming a Claims Examiner, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Claims Examiner for your reference.

Step 1: Understand the job description and responsibilities of an Accountant.

Quotes from people on Claims Examiner job description and responsibilities

Most medical claims examiners deal with paperwork on a daily basis and they are expected to work on multiple claims per day.

04/03/2022: Springfield, MA

Each claim often comes with supporting documents such as medical records and hospital bills and examiners need to look over each file carefully.

03/08/2022: Manchester, NH

Claims examiners are responsible for approving or rejecting claims or arranging settlements.

01/25/2022: Santa Fe, NM

Examiners may review medical bills or accident reports and they may consult specialists.

01/30/2022: Santa Barbara, CA

The Claims Examiner maintains a full case load of professional liability claims.

01/24/2022: Monroe, LA

Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.

Career tips from people on Claims Examiner jobs

Keep reading to learn more about a claims examiner role.

03/28/2022: Oklahoma City, OK

Candidates should know that having a critical thinking and outstanding decision-making give examiners the logic and reasoning to evaluate and resolve claims.

04/05/2022: Tulsa, OK

Most employers require or strongly prefer medical claims examiners that have some medical background such as a postsecondary diploma.

03/11/2022: San Antonio, TX

To determine whether a claim should be rewarded, an examiner must be aware of the red flags associated with fraudulent claims and possess detailed analysis skills.

01/30/2022: Bellingham, WA

To begin a career as a medical claims examiner, one must first learn certain knowledge and skills that will help them execute the duties of the job.

02/17/2022: Lawton, OK

Step 3: View the best colleges and universities for Claims Examiner.

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