Lead Claims Operator

About Benecard and our affiliated companies

Benecard Services, LLC

The Lead Claims Operator will monitor daily insurance claims and workload balancing, perform quality control reviews and error corrections, assist with batching, corrections, reversals and escalations, keying medical optometry and complex claims.

This is a Union position, the salary will start at $22.38/hour and increase to $23.07/hour after 90 days of continuous satisfactory work. Required to be in office 5 days a week in the Clifton, New Jersey location.

• Coordinate and assign daily workflow to ensure timely and accurate claims
• Perform duties such as electronically saving batches, responding to emails, and viewing plan sheets to ensure accurate payments
• Review data for deficiencies or errors, correcting errors and conducting weekly quality assurance on direct member reimbursement claims
• Monitor productivity, turn times, audit results and accurate metrics
• Maintain 99.9% accuracy rate on claims, adjustments and corrections.
• Present and conduct routine and targeted audit review of claims.
• Analyze audit findings, identify error trends, and implement corrective action plans.
• Assist with batching, claim corrections, reversals, medical optometry claims and claim reprocessing projects.

• High School diploma or equivalent is required
• 3-5 years of proven insurance claims experience is required
• Must be proficient in computer skills, Microsoft office and Adobe.
• Must have advanced knowledge of Excel to be successful
• Ability to maintain a high level of accuracy and attention to detail in claims processing and data entry
• Strong analytical and problem-solving skills
• Strong communication and leadership skills
• Familiarity with the AS400 is a plus
• Professional verbal and written communication skills
• Must be dependable and have good attendance history

• Vacation and Sick/Personal Time
• Medical Insurance / Prescription / Vision / Dental
• Hearing Program Discount
• Short- & Long-Term Disability Insurance
• Life Insurance
• Flexible Spending Account
• 401(k) plus company match
• Employee Referral Program
• Employee Recognition
• Tuition Reimbursement
• Professional Development Training

Benecard Services, LLC has been administering carve-out, fixed rate insured prescription drug benefit programs since 1990. Benecard is a full service, in-house prescription benefit administrator that includes mail and specialty drug dispensing. We are a premiere nationwide Prescription Benefit Administrator headquartered in Lawrenceville, New Jersey.

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Bene Card PBF provides self-funded prescription benefit program administration with a personalized approach through focused, clinical expertise. Our business model operates on a customized claim processing system offering unlimited capability and flexibility to respond to client needs in an evolving marketplace. Advanced clinical programs and advanced technology provide the framework to maximize the use of all data elements available. This allows Bene Card PBF to filter the information, focus on clinical opportunities and facilitate interaction between the physician, the pharmacist and the patient to effectively promote complete health care.

Headquartered in Bonita Springs, Florida.

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National Vision Administrators has been meeting the vision benefit needs of public employer groups, Health & Welfare Funds, Associations and Coalitions for over 40 years. Providing millions of people throughout the United States with vision care programs that help them be smarter buyers of eye care and eyewear, NVA is particularly well suited to address today's health benefit challenges as it relates to eye care.

We offer cost-effective, customized vision benefit programs that are clinically integrated. We are proud of the fact that we have retained over 99% of our clients and believe it is the greatest testimony to the high-quality benefits and service satisfaction we provide to both our clients and their members. Headquartered in Clifton, New Jersey.

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We are an equal opportunity employer

Monday - Friday 8:30am - 5:00pm