Senior Claims Examiner

Health Plans Inc•Remote, US,

5d•$24 - $28•Onsite

About The Position

HPI is a respected industry leader with over 44 years of experience, known for its innovation and adaptability. As a third-party administrator, HPI offers a suite of health and benefit solutions to employers. The company fosters a supportive and inclusive work environment where innovation thrives and invests in its team’s growth and well-being to ensure exceptional service. Joining HPI means contributing to ideas that make a real difference for employers and employees nationwide.

Requirements

High School diploma or equivalent
One to two years’ of HPI claims processing experience
Proficient in Microsoft Office, including Word, Excel, Outlook and PowerPoint

Responsibilities

Processing of complex medical, dental, and/or short-term disability claims in accordance with applicable plan benefits.
Completion of claims related special projects as assigned by area management.
Internal auditing and training.
Process claims in accordance with plan benefits.
Maintain quality average of 98%.
Handle correspondence from Plan Correspondent and/or employees in a timely and efficient manner.
Work with staff on filings for claim benefits investigation (pre-existing condition, medical necessity reviews, etc.) as required in accordance with the plan benefits.
Provides assistance to examiners to ensure accurate timely claims processing.
Perform other various tasks that are deemed necessary and equitable by the claims supervisor.
Special projects as determined by area management.