Medical Benefit Specialist

Job Summary

Managing the day-to-day activities of multiple medical benefit copay programs, the full-time Medical Benefit Specialist will assist provider offices with inquiries related to medical claims, troubleshoot issues, and collaborate with external vendors to resolve escalations.

Key responsibilities

• Acts as the focal point for provider medical claim escalations and delivers detailed information to stakeholders
• Conducts outreach to provider sites, patients, and other stakeholders, ensuring exceptional customer service
• Maintains records and evaluates programs to recommend improvements while participating in team meetings and initiatives

Required qualifications

• Associate or Bachelor's degree preferred; or a minimum of 5 years of customer service/medical claim experience
• Strong understanding of medical claims processing and provider workflows
• Proficient in Microsoft products, particularly MS Excel, for data analysis
• Experience managing vendors and collaborating between client-facing and operational teams
• Ability to thrive in a dynamic, fast-paced environment while managing multiple escalations