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OPERATIONS PAYMENTS PROCESSING SPECIALIST
Join our team of professionals with a shared a passion for quality health care at an affordable cost
Sheboygan, WI
Job Description
OPERATIONS PAYMENTS PROCESSING SPECIALIST
Prairie States Enterprises is seeking to fill our open full-time Operations Payments Processing Specialist. This position is in our Sheboygan office, hours are M-F, 7:00-3:00.
Position Summary
Position responsibilities include the processing of claim payments to providers and members on behalf of our client companies following established procedures.
Highlighted Essential Functions
Position Summary
Position responsibilities include the processing of claim payments to providers and members on behalf of our client companies following established procedures.
Highlighted Essential Functions
-
- Follow our daily documented process producing medical and flexible spending claim check runs.
- Manage Explanation of Benefits (EOB) and Explanation of Payment (EOP) formatting, testing, and implementation
- Act in a liaison role to banking entities for Electronic Fund Transfers (EFT’s) checks, and positive pay files
- Reconcile claim files processed, and troubleshoot errors in data files and transmission processes
Education
- High School Diploma or GED required with post-secondary education in business or computer related field highly preferred.
Experience
- 3-5 years prior financial services experience in payment processing, ACH, EFT, and file transfers. Prior insurance claims processing experience is a plus
Specific Technical Position Skills & Abilities:
- Able to independently plan, organize, and manage work activities to meet deadlines.
- Familiarity and competency in the use of electronic payment systems
- Strong customer service and phone skills required
- Possesses strong problem resolution skills
- Possesses strong oral and written communication skills
- Proficient computer skills in Microsoft Office environment required
Prairie States Enterprises, Inc. is a third party administrator, a benefits industry leader, and a trusted advisor to self-insured companies and their employees. We provide a complete range of medical benefit management and claims services, all performed in-house, and to exacting standards of excellence.
Prairie States' Vision is to be a Third Party Administrator that stands apart as a team of passionate people driven by a quest for excellence, who strive to improve the health status and benefit plan experience of our client companies, their employees and families across the nation.
Competitive compensation with a comprehensive benefits package to include the following: generous Paid Time-Off Plan, wellness incentives and fitness membership reimbursement, paid lunch hour, annual service recognition awards, educational assistance, and a lucrative 401 (k) match.
Just as we are committed to improving the lives of our members, we are equally committed to cultivating the careers of forward-thinking professionals. Our corporate culture is one of ambition, integrity, empowerment, teamwork and a passion for personal and company success.
If this sounds like you, and you’re looking for career growth with an industry leader, please respond with your cover letter and resume in the application process with wisconsinjobnetwork.com. Visit us at prairieontheweb.com.
Prairie States' Vision is to be a Third Party Administrator that stands apart as a team of passionate people driven by a quest for excellence, who strive to improve the health status and benefit plan experience of our client companies, their employees and families across the nation.
Competitive compensation with a comprehensive benefits package to include the following: generous Paid Time-Off Plan, wellness incentives and fitness membership reimbursement, paid lunch hour, annual service recognition awards, educational assistance, and a lucrative 401 (k) match.
Just as we are committed to improving the lives of our members, we are equally committed to cultivating the careers of forward-thinking professionals. Our corporate culture is one of ambition, integrity, empowerment, teamwork and a passion for personal and company success.
If this sounds like you, and you’re looking for career growth with an industry leader, please respond with your cover letter and resume in the application process with wisconsinjobnetwork.com. Visit us at prairieontheweb.com.
Job Summary
Company
Start Date
Immediate
Employment Term and Type
Regular, Full Time
Hours per Week
40
Work Hours (i.e. shift)
7:00 - 3:00
Salary and Benefits
Competitive compensation based on experience and a comprehensive benefit package provided to the selected candidate.
Required Education
High School or Equivalent
Required Experience
3 to 5 years
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