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Claims Reviewer

Company Name:
WageWorks
1. POSITION SUMMARY
1. The claims reviewer is responsible for reviewing and processing FSA clams in accordance with IRS regulations and guidelines. The review and processing is performed on our proprietary systems in a relatively paper free environment.
DUTIES & RESPONSIBILITIES
1. Determine if a claim is qualified per IRS regulations
2. Produce Request for Information (RFI) form with specific details regarding the claim in question
3. Suspend and deny claims that are not qualified medical expenses or do not contain appropriate substantiation - document these situations on the participant record in clear and specific language
4. Process both web (online) claims and paper (mailed or faxed) claims
5. Ability to respond to and research inquiries regarding participant claims
6. Ability to interpret and comprehend information regarding systems, administration and procedures
7. Work overtime as needed
1. QUALIFICATIONS & CRITICAL SUCCESS FACTORS
1. Accurate data entry skills
2. Attention to detail and the ability to prioritize work are key functions of this position
3. Exceptional documentation skills
4. Must be able to work in a team setting and independently
5. Willing to learn new procedures and adapt to system enhancements/changes
6. Ability to communicate in a professional manner to peers and co-workers
2. REQUIRED EDUCATION
1. High school diploma or equivalent
2. Minimum of one year of previous office experience
3. ADA REQUIREMENTS
1. None
INFORMATION SECURITY REQUIREMENTS
1. Employee shall agree to and sign terms and conditions of employment documents before any access is granted
2. Employee shall read and adhere to Benefit Concepts Information Security Policy
3. Employee shall protect all Company assets from unauthorized access, disclosure, modification, or destruction
4. Employee shall immediately report any known or perceived security and privacy incident or security weakness
Location: East Providence, RI
Secondary Location(s): East Providence, RI
Job Code: 1649
# of Openings: 1

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