3 jobs found in Sparks, MD

Position Summary The Medical Claims Adjustor provides customer service and processes routine health and welfare claims on assigned accounts according to plan guidelines and adhering to Company policies and regulatory requirements.   "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role."   Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s) and effectively applies that knowledge in the payment of claims. Processes routine claims which could include medical, dental, vision, prescription, or Workers’ Compensation.  May provide customer service by sending out pending letters. Performs other duties as assigned.   Minimum Qualifications High school diploma or GED. Six months of experience processing health and welfare claims. Basic knowledge of benefits claims adjudication principles and procedures and medical and/or dental terminology and ICD-10...

Position Summary The Account Manager reports to and works directly with the Account Executive to execute Fund administration activities for assigned client(s) in accordance with Company guidelines, client needs, and regulatory requirements. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Provide comprehensive support to the Account Executive (AE) on assigned client accounts, including coordination of account deliverables, regulatory and compliance activities, document and communication management, meeting preparation, vendor coordination, issue resolution, and administrative operations. Serves as a primary point of contact for clients and vendors in the AE’s absence. Collaborate with internal departments to revise or create notices, forms and other documents; implement required programming changes; ensure timely mailings and...

Position Summary The Retirement Benefits Specialist performs technical and administrative duties associated with the processing and verification of participants' retirement benefit inquiries and applications in accordance with Company policies, regulatory requirements, and plan guidelines. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role." Key Duties and Responsibilities Maintains current knowledge of assigned Plan(s). Scans applications and all relevant documents into appropriate system. Processes retirement benefit applications; verifies the accuracy and completeness of information, researches or investigates past service, related credits, and insurance deductions. Responds to inquiries from participants, beneficiaries, and union representatives, directly or indirectly, regarding retirement benefits. Determines benefit eligibility and requests necessary documentation...