Healthcare Claims Adjudication Team Member

Education Mandatory: Any Graduate (BSC/BCOM/BA) Desirable: Nil Experience Minimum 6 Months eligibility/enrolment experience (preferred) Technical Competencies: (Job related) Exceptional data entry skills with high attention to detail, strong organization skills and ability to multi-task Should have working knowledge of MS-Office: (Teams, Outlook, Excel, Word, OneNote) Soft Skills: (Job related) • Effective verbal and written communication skills and excellent interpersonal skills • Ability to work effectively with team members, employees/members, providers, and clients and vendors • Ability to use common sense understanding to carry out instructions furnished in oral, written or diagram form • Flexible; open to continued process improvement, with a positive attitude and willingness to learn • Ability to work remotely; o Secure, reliable high speed internet access o HIPAA complaint workspace; preferably in a room that can be secured o Ability to work independently and free from distractions to productivity and accuracy • Demonstrated critical thinking and problem-solving skills Others Mandatory: Nil Desirable: • Bachelor’s degree • > 1 year Eligibility experience • Prior EDI experience (ANSI 834s) • Prior experience in a medical office or provider billing environment • Self-Funded Insurance/Benefits and/or TPA experience • Prior experience with COBRA, FMLA, LOA and retiree administration/coordination experience. • Knowledgeable in handling various types of Federal, State and Company leave programs. • Customer service experience in a professional setting • Prior PowerStepp or other AS400 system experience • Knowledge of COBRA laws, HIPAA portability and eligibility laws