Entry Level Claims Rep

We are seeking to add new team members onto our Benefits Claims team. This is a high growth opportunity with internal training and advancement provided.

Candidate Profile:

Bachelor Degrees and/or equivalent work experience.

We are seeking a candidate who will be able to grasp the complex topic of claims processing in a fastpaced work environment with a focus on resolving the backlog of claims.

Ideal candidate would have ability to pick new things up fast and problem solve through variety of different problems while resolving these claims.

Excellent communication skills are necessary as these analysts would have to be able to interact with different departments.

Duties and Responsibilities

• Collect, analyze, and utilize data and feedback related to Claims to identify opportunities to improve the relationship between the business and the other entity. This will include direct communication and participation with the Vendor Management Office (VMO) and Transformation Management Office (TMO). Compile reports about incidents, events, and updates regarding claims processing issues and conflicts.
  • Gathers, reviews, and analyzes information to identify trends, issues, and potential problems and solutions related to development and implementation, including but not limited to new products or services, contract deliverables, enhancements to add functionality and/or redesigns of systems, both manual and automated, to improve efficiency, financial models of costing and pricing. This includes reviewing and validating new implementations.
  • Initiates in the development of strategies and tactics based on logical assumptions and facts considering resources, constraints, and values.
  • Initiate change and evaluate impact.
  • Conducts ongoing research and analysis to assess changing needs of our industry.
  • Provides quality, objective, and professional analysis.
• Communicate with vendor and internal stakeholders to quickly and accurately obtain or provide information regarding claims processing updates:
  • Works directly with cross-departmental team members to complete tasks and provide status updates. Works with departments and external partners to monitor, collect, communicate, and distribute information.
  • Communicates analysis, assessments, recommendations and completed work product through professional written and verbal reports and presentations. Conducts presentations to all levels of the organization (unit meetings, department meetings, management meetings, etc.) and our vendor partner to ensure reporting of quality outcomes are consistent and understood.
  • Communicate process changes to vendor to stay current with government and commercial health plans, agencies, and other entity's guidelines.

 Top Skills' Details

1. Ability to pick up new subject matter fast

2. Excellent troubleshooting ability and problem solving

3. Excellent communication skills (written and verbal)

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.