Claims Specialist

The Claims Specialist is responsible for properly reviewing and processing claims for various Employer benefit plans according to IRS regulations and specific employer plan rules. A Claims Specialist should be prepared to work in a detail oriented and fast paced environment with a high level of accuracy.

Essential Duties:

• Daily claim processing.

• Accurately process all FSA claim types.

• Determine eligibility by utilizing available resources.

• Ensure priority of workload is followed and turnaround times are met.

• Properly process claim appeals.

• Troubleshoot software issues accordingly.

• Assist with other operational functions.

• Coordinate with other departments when appropriate.

• Assist Claims Supervisors with projects as assigned.

• Work with Claims Supervisors to develop new processes and procedures.

• Continuous improvement approach to work.

• Communicate changes needed for processes.

• Develop and update procedures as needed.

• Promote continuous learning and sharing of knowledge.