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Benefits & Claims Services Associate

Description

We are seeking a dedicated and experienced Benefit & Claims Services Associate to join our team in Grand Cayman.

Reporting to the Manager of Claims & Customer Service, you will be responsible for assisting members, providers, brokers, and employers with benefit inquiries, claims processing, eligibility, network, and medical management questions.

The ideal candidate will have a strong background in health insurance and claims processing, along with excellent customer service and problem-solving skills.

What you’ll do

  • Receive phone calls and written inquiries regarding benefits, claims, eligibility, and other business areas.
  • Process medical, dental, and vision claims as directed.
  • Provide accurate and timely responses to client inquiries.
  • Process incoming requests according to established department policies and procedures.
  • Conduct research and investigative activities to resolve inquiries fully.
  • Collaborate with team members and other departments to resolve and escalate inquiries as needed.
  • Provide timely feedback to customers through outbound calling, email, or mail.
  • Report service failures, systemic issues, or customer concerns to management.
  • Assist in completing special projects and evaluating and revising department policies and procedures.
  • Document and write policies & procedures as needed.
  • Meet or exceed service level agreements for the member services team.
  • Attend and participate in meetings and training sessions as required.
  • Perform other duties as assigned.

What you’ll bring

  • Minimum of 2 years of experience in health insurance and 1 year of claims processing experience.
  • Expert-level knowledge of CPT/CDT/ICD coding.
  • Strong understanding of healthcare billing and claims.
  • High level of resolution skills and proficiency in managing confidential information.
  • Clear verbal and written communication skills.
  • Proficiency in Word, Excel, and computer skills at an experienced level.

Join our client’s team and help us deliver exceptional service to our clients while contributing to a positive and dynamic work environment. Apply today to make a meaningful impact!
 

Send your resume through to Niamh | niamh@steppingstonesrecruitment.com

Caymanians or those with Caymanian rights to work need only apply.

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