Specialist, Claims and Adjustments - FEP

Job description

Healthy Careers Start Here Job Summary The FEP Claims and Adjustment Specialist is responsible for maintaining inventories which focus on the accurate and timely processing of member claims and benefit plan updates. The FEP Claims and Adjustment Specialist will process claims in both the NAS (internal system) and FEP Direct (external system). In addition, the FEP Claims and Adjustment Specialist is responsible for reviewing and taking action on communication received from providers and members via written communication and inquiries received from Customer Service Support. Job-Specific Requirements Bachelor’s degree required. Must have average PC skills including experience with Microsoft Office suite. Logical thought process in order to interpret and apply contract benefits as well as identify issues, recommend solutions, interpret and apply contract benefits and accurately adjust claims. Customer focused and service oriented to ensure timely and accurate performance and benchmark achievement. Ability to work with a high degree of accuracy and attention to detail to ensure work products are of high quality. Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers.