claims specialist. + earth city , missouri + posted october 16, 2024 **job details** summary + $30 - $35 per hour + temp to perm + associate degree + category personal care and service occupations + referenceAB_4630006 job details We are looking for a driven Claims Operations Specialist to join a growing team located in Earth City, MO, 63045. The claims specialist will be responsible for working with internal and external partners to help manage client data. The ideal candidate will have previous experience working with claims, and have great attention to detail. Knowledge of benefit accumulators, eligibility, and data extracts preferred. Please if interested! Pay: $65,000.00 - $75,000.00 Schedule: Monday -Friday , 9:00am - 6:00pm salary: $30 - $35 per hour shift: First work hours: 9 AM - 6 PM education: Associate Responsibilities + Conduct quality assurance audits of pharmacy claims, vendor files, and operations tickets + Manage day-to-day process (i.e. audit benefit accumulator files, work daily reject and QA reports) + Troubleshoot and perform research on data integration issues, JIRA tickets, and escalations + Translate business needs and processes into clear and concise documentation + Monitor client implementation activities, identify, and escalate any at-risk milestones + Support the reporting needs of the department + Manage member and pharmacy related requests via Jira and resolve within the agreed upon Service Levels Skills + Claims Processing + Claims + Medical Claims + Basic Software Skills + Verbal Communication + Written Communication + Analytical Thinking + audit Qualifications + Years of experience: 1 year + Experience level: Experienced Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status. At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com. Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility). This posting is open for thirty (30) days. **get in touch** we are here to help you with your questions. LS **leah sosa** + leah.sosa@randstadusa.com