Benefit Claims Analyst and Adjudicator (Cervey Platform)

Location: Remote

Employement Type: 6 months Contract to Hire

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We are seeking a talented and experienced Benefit Claims Analyst and Adjudicator to join our team and support our PBM client.

Job Description:

As a Benefit Claims Analyst and Adjudicator, you will be responsible for processing, reviewing, and adjudicating benefit claims using Cervey platform. You will play a critical role in ensuring accurate and timely claim payments while providing exceptional customer service to our clients and members.

Responsibilities:

* Process benefit claims accurately and efficiently using Cervey software

* Review and verify claim documentation for completeness and accuracy

* Adjudicate claims based on established criteria and guidelines

* Research and resolve claim discrepancies or issues

* Communicate effectively with clients, members, and providers to address claim inquiries

* Adhere to strict compliance regulations and quality standards

* Assist in identifying and implementing process improvements

* Maintain up-to-date knowledge of benefit plans, policies, and procedures

Qualifications:

* Bachelor's degree or equivalent experience

* Experience processing benefit claims and claim adjudication

* Proficiency in Cervey software is mandatory

* Strong analytical and problem-solving skills

* Excellent attention to detail and accuracy

* Excellent written and verbal communication skills

* Ability to work independently and as part of a team