Kforce has a client that is seeking a Claims Adjuster in Wyomissing, PA. Responsibilities: Adjudicates claims and provides service to clients, claimants, and providers. Meet or exceed defined processing production standards, processing accuracy standards and customer service accuracy standards. Examine, process, calculate and adjudicate claims in compliance to plan documentation Process any open audits daily Follow daily direction to process high dollar claims and other priorities/issues listed on the daily reports that are distributed twice each day (morning and afternoon) Maintain customer service logs within a 5 day turnaround time Maintain HR logs within a 2 day turnaround time Comply with state laws, policy, company procedures, and plan documentation Enter codes, and verify data for computer processing Meet or exceed daily claim production goals. If Customer Service department requires assistance, provide backup customer service to claimants, providers, and clients with problems or questions regarding their claims and/or policies via telephone or correspondence. Maintain customer service logs and HR logs as stated above, plus meet or exceed customer service quality standards. Complete special projects as assigned
Requirements 1 – 3 years healthcare benefits claims adjusting experience is required
Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.
Kforce is a professional staffing services firm offering Technology and Finance & Accounting jobs with top employers nationwide. We specialize in providing contract, contract–to–hire and direct placement opportunities, with over 50 years of experience in the staffing industry. Kforce offers many consultants comprehensive benefits depending on employment status, including medical, dental, 401(K), life insurance and disability. Our vision is to be "the firm most respected by those we serve."