Medical Claims Adjuster

A Chicago-area health insurance fund for union employees is seeking a medical Claims Adjustor. You must have prior experience paying medical claims under a health insurance plan, either for a benefit fund, a third-party administrator, or an insurance company.

We are looking for someone who has a thirst for social and economic justice, wants to help people, and has a history of leadership and improving their community. Sharp attention to detail, professional telephone manners and good interpersonal skills are important. S/he must have the ability to work well independently and as a team player.

 

S/he will be responsible for assisting in the completion of all administrative tasks including claims validation and adjudication, and dealing with participants on the phone and in person. Duties include but are not limited to:

·         Provide customer service to union members on inquiries about medical bills, claims, eligibility, appeals, documentation, and other matters.

·         Discuss claims with participants via written or oral communication.

·         Communicate with Claims Manager about claim problems.

·         Communicate with providers and hospitals about medical bills.

·         Communicate with participating Employers about the benefit plan.

·         Contact with other insurance about Coordination of Benefits.

·         Obtain additional information from hospitals, doctors, attorneys and state agencies when necessary.

·         Request additional information not supplied by participant.The ideal candidate will have several years of health insurance claims paying and customer service experience. A bachelor’s degree, and experience with unions is preferred but not required. In addition, a candidate should possess good communication and computer skills, knowledge of employee health plans, and the ability to write well.

Fluency in both English and Spanish (or Polish) is a big plus and will be compensated appropriately.

Starting salary will depend on experience, but will be no less than $30,000. The competitive compensation package also includes generous family health insurance, a defined benefit pension plan, and paid time off.  

The position is available immediately.

To apply, please send resume and a cover letter to seiu4.hwp.fund@sbcglobal.net . We are an Equal Opportunity Employer and encourage applicants from all backgrounds. We appreciate the opportunity to review all resumes, however only applicants to be interviewed will be contacted.