Specialist, Claims and Adjustments - FEP

About the role

The FEP Claims and Adjustment Specialist is responsible for maintaining inventories which focus on the accurate and timely processing of member claims and benefit plan updates. The FEP Claims and Adjustment Specialist will process claims in both the NAS (internal system) and FEP Direct (external system). In addition, the FEP Claims and Adjustment Specialist is responsible for reviewing and taking action on communication received from providers and members via written communication and inquiries received from Customer Service Support.

Requirements

• Bachelor’s degree required
• Must have average PC skills including experience with Microsoft Office suite
• Logical thought process in order to interpret and apply contract benefits as well as identify issues and recommend solutions
• Ability to interpret and apply contract benefits and accurately adjust claims
• Customer focused and service oriented to ensure timely and accurate performance and benchmark achievement
• Ability to work with a high degree of accuracy and attention to detail to ensure work products are of high quality