Lifetime Benefit Solutions
FSA Claims Processor I - Lifetime Benefits Solutions (LBS) - 014843 (Maintenance)
PLEASE NOTE: With limited exceptions, our company is requiring all employees to be vaccinated against COVID-19 by Jan. 1, 2022. We also currently mandate vaccinations for employees who enter our buildings. Please keep this in mind when applying for positions at our organization.
Summary
Under the general supervision of the department Supervisor, the FSA Claims Processor is responsible for the timely and accurate coding and adjudication of the benefit Plan claims in accordance with the Internal Revenue Service Sections 125, 105, and 132 regulations and guidelines, ERISA, plan documents and department policies and procedures.
Essential Responsibilities/Accountabilities
Level I
• Codes, keys, and processes of all claims data relevant to the Flexible Spending Account, Health Reimbursement Account, and Parking/Transit Accounts in accordance with the Internal Revenue Service, ERISA, plan documents, client administrative guidelines and department policies
• Processes, and evaluates of data files for claims submissions that include manual, debit card, Automatic Claims Transfer (ACT), and Web submitted claims.
• Maintains knowledge of government rules and regulations affecting the definition of eligible expenses and other items that may impact the plan rules.
• Processes adjustments, conducts claim reviews and assists in the resolution of issues/questions arising from participant contact with Customer Service
• Initiates phone calls or written correspondence for additional or missing information necessary to complete the adjudication of a claim. Logs and tracks all send backs, and audit request information.
• Makes on-line error correction of claims.
• Tracks productivity data and /or other data as specified for inventory tracking and control.
• Facilitates the RFI or RMI letter process on an as specified basis.
• Obtains and maintains system knowledge of any/all systems pertinent to FSA, HRA, Parking/Transit claims.
• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values and adhering to the Corporate Code of Conduct, and Leading to the Lifetime Way values and beliefs.
• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
• Regular and reliable attendance is expected and required.
• Performs other functions as assigned by management.
Level II – performs similar functions as level I, plus:
• Acts as a resource for other Claims Processors.
• Assists in the training of newly hired Claims Processors.
• Assists in testing system functionality.
Minimum Qualifications
Level I
• A high school business education, supplemented by experience in accurate data entry with a minimum of 9000 ksph.
• Medical terminology preferred.
• Familiarity working with Microsoft Excel, and text file manipulation preferred.
• Knowledge of Flexible Spending Accounts preferred.
• Utilizes and maintains knowledge of Section 125, Section 105, and Section 132 Plans.
• Possesses good communication skills (written and verbal).
• Ability to work independently and maintain performance level goals in both productivity and accuracy.
• Good organizational skills.
• Successfully pass a criminal record checkpoint and county criminal record background checks
Level II – requires similar qualifications as level I, plus:
• Minimum of three years of previous experience with Section 125, 105 and 132 plans as claims processor, customer service representative or Client Service representative
Physical Requirements
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The Lifetime Healthcare Companies aim to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve.
Our mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture. We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services. With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce.
OUR COMPANY CULTURE:
Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.
In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.
Equal Opportunity Employer
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)
Non Manager