Exceptions Processor - Hybrid in New Braunfels, TX

Company Overview

Boon-Chapman is not your average Third Party Administrator. In addition to traditional TPA services, Boon-Chapman administers business process outsourcing for insurance entities, and other services through its sister companies. With nearly 55 years in business, Boon-Chapman combines the legacy of a family-owned-and-operated company, with the energy and potential of a fast-growing enterprise of companies. A few of our benefits include:

• Paid holidays & competitive PTO that increases with tenure
• Full benefits package including healthcare, dental, vision, 401(K), paid STD & life insurance and more
• Casual everyday dress
• Unlimited opportunities for growth – success is in your own hands!

Job Overview

Boon-Chapman is looking for an Exceptions Processor for our New Braunfels, Texas office. This position is a full-time position. The Exceptions Processor will be responsible for verifying patients, providers and other coding information of claims to correct the issues that will then enable them to be processed. Handles provider maintenance, data entry, re-pricing of claims, and resolves any other issues that prevent the claim from being worked by the analyst. Must be comfortable reaching out to Providers to request W9 information. Demonstrates a strong understanding of the El Dorado claims system in respect to working exceptions. Reports to the supervisor of Pre-Processing.

Job Responsibilities

• Analyzes claims in exception queue.
• Completes claims for processing.
• Researches various provider resources to determine if a provider is in a network and searches for additional provider information as needed.
• Investigates provider information in the claims system to assist with making assessments for matching incoming claims information.
• Performs data entry
• Maintains set quality and production goals.
• Performs other duties as assigned.

Experience and Education

• Experience in general office work and computer software. At least one year of prior office experience.
• High school diploma or equivalent. Experience and education may be substituted for one another.

Knowledge, Skills and Abilities

• Knowledge of business correspondence, filing, and general office procedures.
• Skill in interpersonal and written communication.
• Skill in making good assessments.
• Ability to analyze information quickly.
• Ability to accurately compile data and perform detailed work.
• Ability to meet deadlines.
• Ability to maintain regular attendance.
• Ability to maintain confidentiality of material and information
• Ability to maintain professional appearance and demeanor.
• Ability to work as a member of a team.