What are the responsibilities and job description for the VP of Claims position at Benefit Administration Services, Ltd.?
About Us: For over 35 years, Benefits Administration Services (BAS) has provided innovating and customized service and solutions to employers. From health and benefit management services to human resources and payroll administration, BAS improves productivity and outcomes using advanced technologies alongside excellent customer service. We provide our clients and their employees with customized benefit packages, accurate and timely claims administration and provide effective ongoing communication to effectively guide our customers through a complex healthcare delivery system.
Why join BAS, Ltd.?
Our People and Services create a personalized benefits and HR experience for our clients.
Compensative benefit package; Medical, Dental, Vision, Life, and many more optional benefits for you and your family.
Paid time off after 60 days.
37 hours work week, 8 am - 4:30 pm Monday - Thursday and 8 am - 3:30 pm on Fridays.
Major Responsibilities
Responsible for setting up new plans or making changes to current medical, dental, and vision plans for self-funded groups. Oversee the Claims Processors and Reinsurance department. Also handles special projects with vendors that may arise. On occasion, processes claims for multiple groups for medical, dental, and vision benefits. Communicate with plan sponsors regarding claims as well as the employees or providers on questions that may arise.
- Build medical, dental, vision plans in current claims paying software for new groups and make changes to current plans as needed. Update plan documents and maintain the website for sponsors, employees and providers.
- Supervise claims processors, reinsurance department, and check printing process as well as setting up new groups with our check printing vendor.
- Pulls in claims from clearing house. Distribute claims to appropriate queues. Resolve any issues related to incoming claims.
- Send Medical Review cases to our vendor and reply to providers or employees once a decision has been made.
- Enter updated W-9 information into our Claims processing system.
- Answer questions regarding coverage and claims procedures for group sponsors, employees, and providers.
- Submit reports to clients and vendors as needed. Provide forms and other claims related materials upon request to clients, insureds, or providers.
- Processes when needed medical, dental, and vision benefits for multiple groups.
- Handle special projects that arise regarding claim changes or issues.
Professional Qualifications
Knowledge - level of education required, special certifications or licenses
- High School Diploma or Equivalent, some college preferred.
Skills - job-specific knowledge and abilities, general business acumen, other required skills
- Basic knowledge of relevant laws and regulations applicable to benefit plans, COBRA, HIPAA, and the Affordable Care Act.
- Strong analytical abilities and critical thinking capabilities
- "Team player" mentality
- Five (5) years of benefits, insurance, medical coding experience.
- Proficient in all Microsoft Office Software.
Professional Competencies - leadership, team building, training, financial skills
- Communicate Effectively
- Customer Focus
BAS is an Equal Opportunity Employer and Prohibits Discrimination and Harassment of Any Kind: BAS is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment. All employment decisions at BAS are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate. BAS will not tolerate discrimination or harassment based on any of these characteristics. BAS encourages applicants of all ages.
