Insurance and Claims Specialist

$45,849 - $45,849/Yr

Health Research - Menands, NY

Full-time - Entry Level

Menands, NY

Professional, Scientific, and Technical Services

About the position

The Insurance and Claims Specialist will provide essential support in processing medical, dental, pharmacy, and home care claims, as well as managing insurance premium processing and payment reconciliation. This role is crucial in assisting individuals with or at risk of acquiring HIV/AIDS by bridging the gap between Medicaid coverage and private insurance, ensuring access to necessary medical services and medications.

Responsibilities

• Provide fiscal hotline and participant support.
• Process medical, dental, pharmacy, and home care claims.
• Handle insurance premium processing and payment reconciliation.
• Manage insurance billing and account reconciliation.
• Conduct recovery efforts related to claims and billing.
• Perform other related duties as assigned.

Requirements

• Bachelor's degree in a related field; OR an Associate's degree in a related field and one year of general office, secretarial, or administrative experience; OR three years of such experience.
• At least one year of customer service experience in a financial or medical field.
• At least one year of experience as a customer service representative, handling a high volume of hotline calls.
• At least one year of accounting experience.
• At least one year of medical claims or insurance experience.

Nice-to-haves

• Bilingual in Spanish.

Benefits

• Health, dental and vision insurance with several comprehensive plans to choose from.
• Flexible benefit accounts for medical, dependent care, adoption assistance, parking, and transit.
• Generous paid time off including paid federal and state holidays, paid sick, vacation, and personal leave.
• Tuition support for educational or training opportunities.
• Retirement benefits through the New York State and Local Retirement System and optional enrollment in the New York State Deferred Compensation Plan.
• Postretirement Health Benefits Plan for qualified retirees.
• Employee Assistance Program providing educational and wellness programs, training, and 24/7 confidential services.