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Claims Advocate- TPA Services
Claims Advocate- TPA ServicesAcrisure • Cadillac, MI, US
Claims Advocate- TPA Services

Claims Advocate- TPA Services

Acrisure • Cadillac, MI, US
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A global fintech leader, Acrisure empowers millions of ambitious businesses and individuals with the right solutions to grow boldly forward. Bringing cutting-edge technology and top-tier human support together, we connect clients with customized solutions across a range of insurance, reinsurance, payroll, benefits, cybersecurity, mortgage services – and more.

In the last twelve years, Acrisure has grown in revenue from $38 million to almost $5 billion and employs over 19,000 colleagues in more than 20 countries. Acrisure was built on entrepreneurial spirit. Prioritizing leadership, accountability, and collaboration, we equip our teams to work at the highest levels possible.

Job Summary :

The Claims Advocate for TPA Services is responsible for the accurate and timely processing of Cafeteria Plan (FSA, HSA, HRA, Parking and Transit and Lifestyle Benefits) claims in accordance with IRS regulations and company policies. This role requires a detail-oriented individual with strong analytical and customer service skills.

Responsibilities :

  • Review and process claims submitted by participants, ensuring accuracy and eligibility.
  • Verify documentation to validate eligible expenses according to IRS guidelines and plan documents.
  • Communicate with participants via phone, email, or written correspondence to resolve claim issues or request additional information.
  • Maintain accurate and up-to-date records of all claims processed and communications with participants.
  • Adhere to HIPAA guidelines and maintain confidentiality of participant information.
  • Meet or exceed established production and quality standards.
  • Assist with other TPA operations tasks as needed.
  • Process claims within established turnaround times.
  • Identify and resolve claim discrepancies or issues.
  • Provide excellent customer service to participants.
  • Stay current on IRS regulations and company policies related to FSA administration.
  • Participate in training and development activities to enhance job skills.
  • Collaborate with other team members to ensure efficient and effective TPA operations.

Requirements :

  • Strong attention to detail and accuracy.
  • Excellent analytical and problem-solving skills.
  • Proficient in data entry and computer skills.
  • Excellent communication and customer service skills.
  • Ability to work independently and as part of a team.
  • Knowledge of IRS regulations related to Cafeteria Plan administration (preferred).

    • Education and Experience :

  • High school diploma or equivalent required; Associate's or Bachelor's degree preferred.
  • Prior experience in claims processing or customer service, preferably in the employee benefits industry.

    • Benefits and Perks :

  • Competitive compensation
  • Generous vacation policy, paid holidays, and paid sick time
  • Medical Insurance, Dental Insurance, and Vision Insurance (employee-paid)
  • Company-paid Short-Term and Long-Term Disability Insurance
  • Company-paid Group Life insurance
  • Company-paid Employee Assistance Program (EAP) and Calm App subscription
  • Employee-paid Pet Insurance and optional supplemental insurance coverage
  • Vested 401(k) with company match and financial wellness programs
  • Flexible Spending Account (FSA), Health Savings Account (HSA) and commuter benefits options
  • Paid maternity leave, paid paternity leave, and fertility benefits
  • Career growth and learning opportunities

    • Acrisure is committed to employing a diverse workforce. All applicants will be considered for employment without attention to race, color, religion, age, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

    Acrisure also provides reasonable accommodation to qualified individuals with disabilities or based on a sincerely held religious belief, in accordance with applicable laws.

    Acrisure is an equal opportunity employer.

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    Service Advocate • Cadillac, MI, US