Claims Account Specialist

Posted: 09/04/2024

Claims Account Specialists are responsible for day to day plan administration of pre-tax benefit plans for an assigned group of clients. This high volume, fast paced position requires strong multi-tasking and organizational skill and includes a high volume of claims processing, issuance of reimbursements, status changes, enrollments, responding to client and participant inquiries and implementation of plan set-ups/changes.

Essential Job Duties and Responsibilities
1. Provide a high level of professional service to DBS clients and benefit plan participants.
2. Responsible for day to day plan administration of pre-tax benefit plans for assigned group of clients. Includes a high volume of claims processing, issuance of reimbursements, plan changes, status changes, enrollments, responding to client and participant inquiries, plan set-up in administration software and implementing plan changes.
3. Effective regular communication with clients via phone and email regarding plan changes, claims processing, updates, questions, etc.
4. Master various PC applications and learn software programs quickly.
5. Maintain current working knowledge of benefit plan designs and IRS regulations regarding plans.
6. Accurately enter and audit participant claims and determine eligibility for reimbursement.
7. Generate reports and audit accuracy of information.
8. Provide assistance to Customer Service Team during peak times when we experience increased claims and call volume.
9. Assist with basic office coverage for team members who are out of the office.
10. Work directly with all company departments to ensure client requests are met and a high level of service is consistently provided.

Required Work Skills
1. Proven ability to provide a high level of customer service.
2. Possess excellent organizational, detail orientation, follow through, analytical and problem solving skills.
3. Possess basic math/accounting competencies required within position.
4. Effective multi-tasking skills.
5. Excellent interpersonal skills and demonstrated professionalism.
6. Ability to quickly change gears and demonstrate flexibility.
7. Proficient in the use of computers and possess the ability to quickly learn new software programs.
8. Solid working knowledge of Microsoft Office (including excel).
9. Able to effectively work with personnel of varied skill levels and work through challenging situations efficiently.
10. Able to handle information confidentially.
11. Minimum of two years of experience in a professional work environment working directly with customers.
12. Previous experience in a claims processing, payroll, banking or insurance environment is required.