What are the responsibilities and job description for the Claims & Adjustment Specialist position at Blue Cross & Blue Shield of Mississippi?
Job Summary :
The Claims & Adjustment Specialists processes claims for fully-insured and self-insured lines of business making logical decisions to ensure accurate application of provider and benefit contract provisions. The Claims & Adjustment Specialist is also responsible for handling claim and adjustment requests resulting from member and providers by communicating effectively with other areas and partner plans. In completing these activities, the Claims and Adjustment Specialist is responsible for achieving established timeliness and accuracy benchmarks, while ensuring that members experience and service expectations are always met.
Job-Specific Requirements :
Bachelor’s degree required.
Must have good computer skills including experience with Microsoft Office Suite.
Logical thought process and critical thinking in order to interpret and apply contract benefits, and to identify potential issues.
Must have customer focused and service oriented mindset.
Ability to work with a high degree of accuracy and attention to detail to ensure work products are of high quality.
Excellent organizational skills in order to successfully prioritize tasks and perform to ensure individual and team benchmarks are consistently met.
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.
