About ComPsych

ComPsych® Corporation is the world’s largest provider of employee assistance programs (EAP) and is the pioneer and worldwide leader of fully integrated EAP, behavioral health, wellness, work-life, HR,

FMLA and absence management services under its GuidanceResources® brand. ComPsych provides services to more than 31,000 organizations covering more than 82 million individuals throughout the U.S. and over 130 countries. By creating “Build-to-Suit” programs, ComPsych helps employers attract and retain employees, increase employee productivity and improve overall health and well-being. For more information, visit www.compsych.com.

Job Summary

The Claims Specialist determines the appropriate reimbursement for Managed Care claims and adjudicates each claim completely and accurately in accordance with company standards.

Primary Responsibilities

  • Processes assigned managed care claims in accordance with accuracy and production standards.
  • Applies the appropriate benefit and rates for each adjudicated claim.
  • Corrects audit error within service standards.
  • Responds to incoming inquiries, complaints and appeals and resolves issues for clients.
  • Assists other specialists, examiners and claims logging, mail clerks and customer service department when workload dictates.
  • Participates in special projects as assigned