Claims and Customer Service Administrator


Position Overview:

The Claims and Customer Service Administrator is responsible for managing and processing multiple client claims, answering client inquiries and troubleshooting claims issues.  The Claims and Customer Service Administrator will support Benefits Consultants in their efforts to service mutual clients.

 

Duties and Responsibilities:

  • Reviews and processes client claims and issues payments for claims in a timely, efficient, and accurate manner
  • Reviews and adjusts claims as needed
  • Balances and runs semi-monthly check cycle
  • Prepares checks for mailing by stuffing, sealing and adding postage when necessary
  • Prepares and processes Transaction Reports for all clients
  • Prepares Actual vs. Anticipated reports on a monthly basis and proactively delivers them to Benefits Consultants prior to quarterly meetings
  • Maintains client information in the database and makes appropriate changes as needed
  • Responds to client telephone and email inquiries with follow up as needed, escalating elevated inquiries immediately
  • Resolves client problems, issues and/or errors in a timely, professional manner and ensures follow up
  • Enrolls new participants into the system
  • Generates new and replacement MRP ID cards
  • Files reissued check copies and group documents
  • Attends weekly staff meetings and reports on weekly metrics, projects and client issues
  • Participates in internal committees
  • Assists in the ongoing development of administration procedures
  • Utilizes CRM database to track, manage, and report all client activities
  • Organizes electronic and hard copy client files and keeps them updated
  • Organizes and maintains client specific information on CPI-HR data systems for easy access and reference
  • Moves clients through the retention funnel, turning clients into advocates and champions of CPI-HR’s services
  • Assists leadership team in the execution of CPI-HR’s Strategic Business Plan

 

Requirements:

  • Education – High school diploma required
  • Experience – Two (2) to three (3) years work experience or equivalent combination of education and experience

 

Other Skills/Competencies:

  • Customer service experience
  • Computer literacy with basic skills in Microsoft Word and Excel
  • Organizational, time management, and problem-solving skills
  • Knowledge of medical claims
  • Intuitive and detail-oriented
  • Self-directed, proactive and able to anticipate needs
  • Effective oral and written communication skills
  • Comfortable working in a fast-paced environment with short deadlines
  • Ability to multi-task
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