Medical Claims Contract Administrator

Responsibilities

As a Medical Claims Contract Administrator, your key responsibilities will include

• Managing and processing new enrollment applications, ensuring all necessary documentation is received, and data is accurately entered into our system.
• Providing top-notch customer service, resolving any issues or concerns raised by our clients and ensuring they have a positive experience.
• Working closely with our call center team, handling inquiries and complaints, providing necessary information, and escalating issues as needed.
• Ensuring all medical claims are processed accurately and in a timely manner, adhering to all contractual obligations.
• Maintaining up-to-date knowledge of all contractual changes and updates, ensuring all claims are processed in accordance to these.
• Collaborating with other departments to ensure seamless service delivery and client satisfaction.
• Identifying opportunities for process improvements, making recommendations, and implementing changes as approved.
• Ensuring compliance with all company policies, as well as local, state, and federal regulations.
  

Qualifications

The ideal candidate for this role will have the following qualifications

• A minimum of 2 years of experience in medical claims administration, preferably within the manufacturing industry.
• Demonstrated experience in new enrollment processes and customer service.
• Proven experience in a call center environment, with excellent communication skills and the ability to handle high-pressure situations.
• Strong knowledge of medical terminology, coding, and billing procedures.
• Exceptional attention to detail, with the ability to manage multiple tasks and deadlines.
• Proficiency in using computer systems and software, including Microsoft Office suite and database management.
• Excellent problem-solving skills, with the ability to think critically and make decisions.
• Ability to work independently, as well as part of a team.
• Bachelor's degree in healthcare administration, business, or a related field is preferred.