Job Summary
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.
Job-Specific 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, recommend solutions, 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.
Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers.
Skills Required
- Bachelor's degree
- Average PC skills
- Experience with Microsoft Office Suite
- Logical thought process for interpreting and applying contract benefits
- Ability to identify issues and recommend solutions
- Customer-focused and service-oriented approach
- High degree of accuracy and attention to detail
What We Do
At Blue Cross & Blue Shield of Mississippi, we work daily to help Mississippians find their personal answers to this question through health and wellness partnerships with quality healthcare providers, employer groups and community leaders across the state. Our goal is to help each person along their journey to a healthier life… their Blue Wellness Journey. Our health and wellness benefits are designed to support our members in understanding their health and in receiving the care they need at the right time and place, beginning with establishing a healthy relationship with a Primary Care Network Provider through an annual wellness visit at no out-of-pocket cost. We partner with our Network Providers to ensure the highest quality, evidence-based care is provided in each care setting from primary care to specialty care through our Primary Care Home, Blue Distinction+ Centers of Excellence and Maternity Care Quality initiatives. We partner with employer groups to make every workplace a healthy workplace by providing tools and information to help employees take ownership of their health and understand and make the most of their benefits, all while working to manage health and healthcare costs. We partner with community leaders and organizations to make healthy living resources available to all Mississippians through the work of the Blue Cross & Blue Shield of Mississippi Foundation, our support of the arts and culture and our Team Blue volunteers. These partnerships and our dedicated team of employees are making a difference every day, in our communities and in the lives of each person we reach. So, what does it mean to be healthy? The answer is about you, your health, your life… and all its possibilities. Live healthy. Live Blue.
