Benefits Review Specialist
Tulsa Metro Area, Oklahoma
Category: Administrative
Reference ID: 10082021
Shortcut: http://addisongroup.gosnaphop.com/xmUfDb
Job Title: Benefits Review Specialist
Industry: Insurance / Healthcare
Location (city, state): Tulsa, OK
Assignment Type: Direct Hire
Pay: $28/hr
Work Schedule: Mon-Fri, 8am-5pm
Benefits: This position is eligible for medical, dental, vision, and 401(k).
About The Company:
Our client is an established organization within the insurance and healthcare services industry focused on delivering accurate, timely, and high-quality claims support. The team values collaboration, attention to detail, continuous improvement, and providing responsive service to clients and business partners.
Job Description:
The Claims Examiner will be responsible for reviewing, evaluating, and processing healthcare-related insurance claims. This position requires a strong understanding of claims procedures, benefit information, documentation requirements, and applicable regulations. The ideal candidate is detail-oriented, analytical, organized, and able to communicate effectively with both internal and external stakeholders.
Key Responsibilities:
- Review submitted claims to verify eligibility, required documentation, accuracy, and applicable coverage.
- Evaluate claims using plan provisions, established procedures, and applicable benefit guidelines.
- Determine appropriate claim outcomes, including approvals, adjustments, payment calculations, or denial determinations.
- Prepare or coordinate claim-related correspondence when additional information or a denial explanation is required.
- Follow applicable federal and state regulations, privacy requirements, and internal claims procedures.
- Maintain complete and accurate records of claims, payments, adjustments, denials, and supporting documentation.
- Respond to questions from healthcare providers, clients, and internal teams regarding claim status and processing decisions.
- Identify potential payment discrepancies, including overpayments and underpayments, and escalate issues appropriately.
- Communicate with external partners and other stakeholders to obtain information necessary to complete claim reviews.
- Confirm member eligibility, benefit levels, authorizations, and coverage details as needed.
- Recognize missing or inconsistent documentation and work with the appropriate parties to resolve outstanding issues.
- Protect confidential information and follow HIPAA and other applicable privacy standards.
- Utilize claims systems, computer applications, and emerging technology tools to improve accuracy, efficiency, and service.
- Contribute to departmental projects, process improvements, and other duties as assigned.
Qualifications:
- High school diploma or equivalent required.
- At least 1 year of experience in healthcare claims processing, reimbursement, or a related field.
- Ability to interpret written policies, benefit information, procedural guidelines, and government regulations.
- Proficiency with standard computer applications, including email, spreadsheets, word processing, and database systems.
- Strong attention to detail and the ability to analyze information and identify discrepancies.
- Effective problem-solving and decision-making skills.
- Strong written and verbal communication abilities.
- Ability to manage multiple priorities and adjust to changing workloads.
- Ability to work effectively with internal teams, providers, clients, and other business partners.
Additional Details:
- This position requires a high level of accuracy and discretion when handling sensitive claims and member information.
- Candidates should be comfortable working independently while also collaborating with a broader team.
- The responsibilities listed above are representative of the position and may be modified based on business needs.
Perks:
- Competitive compensation.
- Medical, dental, and vision benefits.
- 401(k) retirement savings opportunity.
- Paid time off and company holidays.
- Employee assistance and wellness resources.
- Professional development and career growth opportunities.
- Collaborative and supportive work environment.
Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.
#Admin3
-
Claims Examiner - Remote
Tulsa Metro Area, Oklahoma
Job Title: Claims Examiner Industry: Insurance / Healthcare Location (city, state): Tulsa, OK (remote) Assignment Type: Direct Hire Pay: $28/hr Work Schedule: Mon-Fri, 8am-5pm Benefits: This position is eligible for medical, dental, vision, and 401(k)....
Recommended
-
Insurance Follow-Up Representative
Greenville, SC
Title: Insurance Follow-Up Representative Location: Greenville, SC Compensation: $17.50 – $24.50 / hour Benefits: This position may be eligible for medical, dental, vision, and 401(k) benefits, depending on individual selections and applicable work-hou...
Recommended
-
Medical Billing and AR Specialist
Mendota Heights, MN
Title: Medical Biller Location: St. Paul, MN, must be able to work on-site Industry: Healthcare Pay Rate: $23.00 - $29.00 / Hourly Benefits: This position is eligible for medical, dental, vision, and 401(k). Job Description: We are currently hiring for...
Recommended
-
Administrative Assistant
Nashville, TN
Job Title: Claims Administrative Assistant Industry: Logistics Location (city, state): Nashville, TN (37205) Assignment Type: 4 – 5 Month Contract Pay: $30 - $32 / hr Work Schedule: Monday–Friday, 8:00 AM–5:00 PM; Fully Onsite Benefits: This position i...
Recommended
-
Medical Collector (Insurance Follow-up and Appeals)
San Antonio, TX
Position: Medical Collector (Insurance Follow-up/Appeals) Location: Remote (Must be based in San Antonio, TX) Pay Range: $24–$26 / hour Benefits: This position is eligible for medical, dental, vision, and 401(k) benefits. Position Overview: A healthcar...
Recommended
-
Denials Specialist
Houston, TX
Job Title: Denials Specialist Location: Houston, TX (Downtown) Industry: Healthcare / Revenue Cycle Management Pay: $26 - $28 / hr Job Type: Direct Hire Benefits: This position is eligible for medical, dental, vision, and 401k. About Our Client: Addiso...
Recommended
-
Healthcare Customer Service Representative
Rockville, MD
Job title: Healthcare Customer Service Representative Location (city, state): Rockville, MD - Fully Onsite Industry: Healthcare / Health Benefits / Customer Service Pay: $25–$28/hour Benefits: This position is eligible for medical, dental, vision, life...
Recommended
-
Medical Collections Specialist
Maryland
Job Title: Medical Collections Specialist - Hospital Claims Location: Maryland (Remote) Industry: Healthcare RCM Pay: $20.00 - $23.00 / Per Hour (Based on years of experience) Benefits: This position is eligible for medical, dental, vision, life insura...
Recommended
-
Healthcare Account Associate
Bethesda, MD
Job title: Healthcare Account Associate Location: Remote | Travel to Bethesda, MD approximately 35% Industry: Healthcare / Health Insurance Claims Pay: $75,000 - $90,000 / Annually Benefits: This position is eligible for medical, dental, vision, life i...
Recommended
-
Medical Collection Specialist
Bethesda, MD
Job Title: Medical Collection Specialist Location: Bethesda, MD (Onsite) Industry: Healthcare / Revenue Cycle Management Pay: $23 per hour Benefits: This position is eligible for medical, dental, vision, life insurance and 401k. About Our Client Addiso...
Recommended
-
Retina Billing Specialist
Southlake, TX
Role: Billing Specialist - Retina Location: Fully Remote Pay Range: $24 – $30 / hour Schedule: Monday–Friday, 8:00 AM–5:00 PM in the assigned practice's time zone Employment Type: Direct Hire Benefits: This role is eligible for medical, dental, vision ...
Recommended
-
Customer Service Representative
Rockville, MD
Job Title: Participant Advocate / Customer Service Representative Industry: Healthcare Benefits / Insurance Location (City, State): Rockville, MD Assignment Type: Contract-to-Hire; anticipated conversion after approximately 6–8 months Pay: $23.00–$27.0...
Recommended
-
Medical Appeals Specialist
Addison, TX
Arbitration Specialist – Medical Billing / Appeals Location: Addison, TX, fully on site Pay: $23–$29/hour, based on experience Schedule: Monday–Friday, flexible daytime schedule Employment Type: Direct Hire Benefits: Medical, Dental, Vision Position Ov...
Recommended
-
Medical Billing Specialist
North Chicago, IL
Job Title: Medical Billing Specialist Industry: Healthcare Location (city, state): North Chicago, IL Assignment Type: Direct Hire Pay: $18.88 – $22.50 / hour, based on experience. Candidates with extensive specialty billing experience may be considered...
Recommended
-
Medicaid Collections Specialist
Mesquite, TX
Position: Medicaid Collections Specialist (Hospital Revenue Cycle) Location: Remote (U.S. Remote; candidates from select states are not eligible) Pay Range: $23.00 – $26.00 / Per hour Benefits: This position is eligible for medical, dental, vision, and...
Recommended
-
Remote Medicaid Collector
Mesquite, TX
Role: Medical Collections Specialist – Hospital Revenue Cycle Location: Remote Pay Range: $23.00 – $26.00 / Per hour Start Date: ASAP Benefits: This position is eligible for medical, dental, vision and 401(k). This is a long term contract role with pot...
Recommended
-
Payroll Manager
Chantilly, VA
Position Title: Payroll Manager Location: Chantilly, VA (Hybrid – 3 days onsite) Assignment Type: Permanent Hire Compensation: $85,000–$95,000 / Annually Work Schedule: Monday – Friday, 9:00 AM – 5:00 PM Benefits: This position is eligible for Medical,...
Recommended
-
Full-Cycle Billing Specialist
Texas
Job title: Full-Cycle Billing Specialist Location: Texas Industry: Healthcare / Infusion Revenue Cycle Pay: $22.00 - $26.00 / Per Hour (Based on years of experience) Benefits: This position is eligible for medical, dental, vision, life insurance and 40...
Recommended
-
Reimbursement Specialist
Westchester, IL
Job Title: Reimbursement Specialist – Liability Industry: Healthcare / Medical Billing Location: Westchester, IL (Hybrid) Assignment Type: Direct Hire Pay: $22 – $26 / hour (up to $27/hour based on experience) Work Schedule: Full-time, Monday–Friday wi...
Recommended
-
Benefits Strategic Specialist
San Antonio, TX
Job Title: Benefits Strategic Specialist Location: Remote Industry: PEO Pay: $60,000–$70,000 Work Schedule: Monday-Friday, 8:00AM-5:00PM, Fully Onsite Benefits: This position is eligible for medical, dental, vision, and 401(k). About Our Client: Addiso...
Recommended
-
Payroll Specialist
Denver, CO
Role: Payroll Specialist Location: Denver, CO (on site) Salary: $60,000 - $65,000 / year DOE Benefits: This position is eligible for medical, dental, vision and 401(k) We are seeking a detail-oriented Payroll Specialist to support payroll processing fo...
Recommended
-
Medical Biller
Columbia, SC
Title: Medical Biller (Full Cycle) Location: Columbia, SC Compensation: $17.00 – $22.00 per hour Benefits: This position may be eligible for medical, dental, vision, and 401(k) benefits through Addison Group during the contract period. About the Opport...
Recommended
-
Grant Billing Analyst
New York City Metro Area, New York
Role: Grant Billing Analyst Location: New York City, NY Employment Type: Contract to Hire/Temporary to Permanent Rate: $28-34/hr Benefits: This position is eligible for medical, dental, vision and 401k. Summary: Nonprofit organization is seeking a Gran...
Recommended
-
Service Manager
Vernon Hills, IL
Title: Service Manager Onsite: Monday-Friday Location: Northwest Suburbs - Chicagoland Salary: $90,000-$110,000 + Bonus Benefits: Healthcare, Dental, PTO, 401k Position Overview We are seeking an experienced Service Manager to lead all service operatio...
Recommended
-
HR Generalist
Chicago, IL
Job Title: HR Generalist Industry: Higher Education Services Location: Chicago, IL Assignment Type: Temporary Contract – Through End of Year Pay: $24–$28/hour Work Schedule: Monday–Friday, 40 hours per week. Hybrid schedule requiring 2–3 days onsite pe...
Recommended
-
People & Culture Benefits Partner
Chicago, IL
Job Title: People & Culture Benefits Partner Industry: Non-Profit / Social Services Location: Chicago, IL Assignment Type: Direct Hire Pay: $75,000 – $80,000 Work Schedule: 9:00 AM – 5:00 PM or 8:30 AM – 4:30 PM. Hybrid schedule Benefits: This position...
Recommended
-
Case Manager
Colorado Springs, CO
Job Title: Case Manager Location: Colorado Springs, CO (Hybrid Flexibility) Industry: Non-Profit Pay: $20–$22 per hour Benefits: Medical, dental, vision, and 401(k) eligibility Employment Type: 6+ month contract with potential for conversion About Our ...
Recommended
-
Payroll Specialist
Phoenix Metro Area, Arizona
Role: Payroll Specialist Location: Tempe, Arizona Pay Rate: $30/HR - $35/HR Benefits & Bonuses: You are eligible for medical, dental, vision insurance benefits, 401K, and monetary bonuses Internal Job ID: 10068806 Are you looking for a new position in ...
Recommended
-
Payroll Specialist
Englewood, NJ
Job Title: Payroll Specialist Industry: Finance & Accounting, Real Estate/Property Management Location: Englewood, NJ Compensation: $65,000 - $80,000 / Year Benefits: This position is eligible for medical, dental, vision, and 401(k) benefits Work Sched...
Recommended
-
HR Specialist
San Antonio, TX
Job Title: HR Specialist Location: Austin, TX Industry: Financial Services Pay: $26–29/hour Benefits: This position is eligible for medical, dental, vision, and 401(k). About Our Client Addison Group is partnering with a well-established Financial Serv...
Recommended