Available Career Opportunities

Review the openings below and submit resume and salary requirements to employment@gbsio.net.

Broker Sales Representative (Outside)

Position Summary

The Outside Broker Sales Representative will market and sell employee benefit products and services to brokers and their clients of all sizes. This individual will focus on setting appointments with qualified prospects and closing sales. Products include, but are not limited to:

  • Fully-Insured group benefit products and services
    • Medical, Dental, Vision, Life AD&D, Short & Long Term Disability, Voluntary, HRA, FSA, HSA, COBRA
  • Self-Funded group benefit products and services
    • Medical, Dental, Vision, Wellness Programs and other products that may apply
  • Broker Outsourcing Services (Broker Select)
    • Account Management, Renewals, Customer Service, Employee Communications

This position will have production goals and will be expected to meet quarterly sales targets.

Responsibilities

  • Identify potential brokers & clients
  • Contact brokers to establish & maintain business relationships
  • Attain prospecting & sales goals
  • Maintain insurance licensing for appropriate markets
  • Assist broker with new case implementation as necessary (employer meetings, etc.)
  • Other duties as assigned

This list is not intended to be an all-inclusive representation of the responsibilities of this position, but instead, is intended to present a summary of its major functions. Specific assignments may be changed at the discretion of management.

Education, Training, Licensing & Certification Requirements

Life & Health License

Experience Requirements

  • 3-5 years of successful sales experience
  • Relationship building
  • Experience with prospecting/cold-calling
  • Enthusiastic
  • Objective oriented
  • Team oriented
  • Must be proficient with Microsoft Excel, Word, Outlook and PowerPoint
Submit Resume & Salary Requirements
Claims Adjudicator

Position Summary

The Claims Adjudicator is responsible for processing professional and facility medical claims as well as dental and vision claims for payment or denial.

Responsibilities

  • Read, review, and analyze claims for complete information
  • Conduct a thorough investigation of disclosure information and preexisting conditions
  • Verify benefit eligibility/membership and coverage type
  • Determine appropriate copay, coinsurance, and deductible information according to plan documents
  • Adjudicate claims appropriately using departmental procedures and guidelines as applicable
  • Send appropriate correspondence to providers/members requesting additional information as needed
  • Meet or exceed productivity and quality requirements
  • All other duties as assigned

This list is not intended to be an all-inclusive representation of the responsibilities of this position, but instead, is intended to present a summary of its major functions. Specific assignments may be changed at the discretion of management.

Experience Requirements

  • Excellent written and verbal communication skills
  • Excellent analytical skills
  • Extensive knowledge in investigating claims for validity and compensability
  • Ability to identify and investigate insurance disclosures and preexisting conditions
  • Interpersonal skills
  • Excellent organizational skills
  • Ability to work independently
  • Previous experience with Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-9/ICD-10) coding structures
  • Thorough knowledge of Preferred Provider Organization (PPO) structures
  • Successful completion of course in medical terminology
  • Minimum of two years prior experience processing medical insurance claims
Submit Resume & Salary Requirements
Client Service Representative

Position Summary

The Client Service Representative position will be responsible for identifying, researching, and resolving provider/insured inquiries relative to claims, eligibility, and benefits. This position will be part of our Call Center, managing all inbound and outbound calls in a timely manner. The successful candidate will be the liaison between our company and its current customers, taking the extra mile in building positive and sustainable relationships.

Responsibilities

  • Perform thorough and accurate research in a timely manner.
  • Follow-up by telephone or written correspondence with providers/insureds on all relevant claims issues.
  • Communicate effectively with a professional demeanor and maintain a courteous disposition at all times.
  • Verify benefit eligibility/membership and coverage type.
  • Determine appropriate co-pay, coinsurance, and deductible information according to plan documents.
  • Send appropriate correspondence to providers/insureds requesting additional information as needed.
  • Meet or exceed productivity and quality requirements.
  • All other duties as assigned.

This list is not intended to be an all-inclusive representation of the responsibilities of this position, but instead, is intended to present a summary of its major functions. Specific assignments may be changed at the discretion of management.

Experience Requirements

  • Excellent written and verbal communication skills
  • Excellent analytical skills
  • Interpersonal skills
  • Excellent organizational skills and ability to work independently
  • Previous experience with Current Procedural Terminology (CPT) and Internal Classification of Diseases (ICD-9/ICD-10) coding structures
  • Thorough knowledge of Preferred Provider Organization (PPO) structures
  • Successful completion of course in medical terminology
  • Minimum of 2 years' experience processing medical insurance claims or fielding inquiries regarding medical insurance claims
Submit Resume & Salary Requirements
Customer Service Representative

Position Summary

The Customer Service Representative will provide administrative and customer service support to Broker Select and Legacy Accounts (Clients), as well as, the Sales and Sales Support Teams.

Responsibilities

  • Assist with all servicing issues, related products, and services
  • Act as liaison between Sales/Sales Support and Clients on post sale/renewal needs (enrollments and ID Cards, etc.)
  • Act as liaison between Clients and insurance carriers (claims issues)
  • Complete enrollment, claims, HRA, and FSA audits as required
  • Receive all applications (new and existing groups) and review for completeness, acquire missing information, and forward for processing or process directly with carriers as appropriate
  • Respond clearly and accurately to client communications regarding benefits, applications, account status, procedures, etc.
  • Initiate contact with clients by telephone or email regarding questions or problems
  • Maintain knowledge level of benefits, products, laws and regulations, systems, procedures, and communicate this knowledge to clients as necessary
  • Maintain high degree of accuracy and timeliness; meet or exceed the performance standards
  • Ability to analyze processes and procedures to determine most efficient methods of providing administrative support
  • Recommend opportunities for automation and/or reorganization and discuss with supervisor
  • Other duties as assigned

This list is not intended to be an all-inclusive representation of the responsibilities of this position, but instead, is intended to present a summary of its major functions. Specific assignments may be changed at the discretion of management.

Education, Training, Licensing & Certification Requirements

Life & Health License - must be willing to obtain within 3 months of hire date.

Experience Requirements

  • Minimum of three years customer service experience in insurance sales
  • Good math aptitude
  • Excellent organizational skills
  • Ability to prioritize work and meet established deadlines
  • Excellent communication skills
  • Excellent interpersonal skills
  • Basic proficiency with MS Office to include Excel, Publisher, Outlook, and Word
Submit Resume & Salary Requirements
HRA/FSA Analyst

Position Summary

The HRA/FSA Analyst is primarily responsible for the accurate and timely processing of claims and debit card substantiation in the debit card system. The analyst will be responsible for handling client service calls from the Health Reimbursement Account (HRA) and Flexible Spending Account (FSA) members and the employer groups. The analyst will be expected to be cross-trained on all department functions and be willing to adapt his/her workflow to meet department priorities.

Responsibilities

  • Process claims and handle service calls for the HRA and FSA products
  • Document service calls and claim activity in the LuminX claim system
  • Resolve member issues
  • Assist other departments and team members as needed
  • Perform miscellaneous projects
  • All other duties as assigned

This list is not intended to be an all-inclusive representation of the responsibilities of this position, but instead, is intended to present a summary of its major functions. Specific assignments may be changed at the discretion of management.

Experience Requirements

  • Excellent written and verbal communication skills
  • Excellent analytical skills
  • Interpersonal skills
  • Organizational skills
  • Detail-oriented with a high level of accuracy
  • Knowledge of medical coding structures
  • Insurance experience and industry knowledge
  • Thorough knowledge of self-funded benefit plans
  • Minimum of three years prior experience in a claims processing environment in a self-funded setting
  • Basic proficiency with Microsoft Office (Word, Outlook, Excel)
Submit Resume & Salary Requirements
Medical Review and Appeal Analyst

Position Summary

The Medical Review and Appeal Analyst position is responsible for ensuring that all first-level provider and member appeals and medical pre and post-service medical necessity reviews are resolved per established policies and procedure. The primary goals for this position are to ensure accurate and timely processing and communication of medical reviews, appeals, subrogation claims, claim pricing, disclosure investigations and submission of Referenced Based Revenue balance billing disputes along with coordination of such with our outside vendors.

Responsibilities

  • Manages the resolution of post-claim payment appeals and disputes.
  • Investigates all complaints, grievances, and appeals including the collection of appropriate documentation required for submission and review of these cases.
  • Works with various vendors in submitting appeals and disputes for Preferred Provider Organization (PPO) network contracts and Medicare referenced based pricing.
  • Scanning, compiling and submitting the appeals/disputes into various vendor pricing systems.    
  • Develop and maintain daily logs of appeal submissions along with tracking the resolutions.  
  • Coordinates the resolution with the claims and customer service staff to include writing up requests for any adjustments and/or overpayments and documentation in the Luminx claims system.  
  • Implement a follow-up process to ensure timely resolution of the appeals/disputes sent to outside vendors.
  • Investigate any possible undisclosed conditions for groups that are medically underwritten.
  • Coordinate and manage the Third Party Subrogation Program with our outside vendor to include submission of potential third party claims and vendor requests required for the settlement of these cases. 
  • Communication via email or phone to the various vendors with questions or status requests.
  • Makes any necessary contacts with patients, members, and providers regarding the Health Plan’s determination to ensure timeframes are met. 
  • Coordinate and review out of network claim submission to the negotiation vendor for potential savings and applicable contract discounts
  • Coordinate disputes and balance billings on Referenced Based Revenue priced claims to our various vendors.
  • Assist with in house PPO and Medicare pricing programs to ensure timely turnaround.
  • Communicate any issues or problems to the Management team.
  • Act as a resource for questions from departmental staff regarding appeals and medical review submissions.
  • Assist the Management Team with specific duties as assigned to include all aspects of claims processing.
  • Ensure compliance of Health Insurance Privacy Accountability Act (HIPAA) privacy rules in daily client interactions and claims processing.
  • All other duties as assigned.

This list is not intended to be an all-inclusive representation of the responsibilities of this position, but instead, is intended to present a summary of its major functions. Specific assignments may be changed at the discretion of management.

Experience Requirements

  • Knowledge of the health insurance industry.
  • Excellent written and verbal communication skills.
  • Excellent analytical skills.
  • Prior appeals experience. 
  • Excellent interpersonal skills. 
  • Excellent organizational skills. 
  • Previous experience with Current Procedural Terminology (CPT), International Classification of Diseases (ICD-9 & ICD-10) coding structures. 
  • Medical terminology knowledge. 
  • Knowledge of Windows PC applications required (Microsoft Office, Excel preferred). 
  • Minimum of three years prior experience in a claims processing environment at the management level, preferably in a self-funded setting.
Submit Resume & Salary Requirements
Pharmacy Benefit Manager Coordinator

Position Summary

The Pharmacy Benefit Management (PBM) Coordinator position is responsible for accurate and timely creation of the daily Rx claim spreadsheet and processing of the Rx claims in the LuminX system. The PBM Coordinator will also be available to assist other members of the Business Analysis team as needed on other invoice claim processing.

Responsibilities

  • Create the daily Rx spreadsheet received from the Rx vendor(s)
  • Process the Rx claims in the LuminX claim system
  • Run a daily audit to verify the accuracy of the prior day's claim processing activity
  • Research and execute LuminX adjustments in an accurate and timely manner
  • Process invoices
  • Assist other departments and team members as needed
  • Perform miscellaneous projects
  • All other duties as assigned

This list is not intended to be an all-inclusive representation of the responsibilities of this position, but instead, is intended to present a summary of its major functions. Specific assignments may be changed at the discretion of management.

Experience Requirements

  • Excellent written and verbal communication skills
  • Excellent analytical skills
  • Interpersonal skills
  • Organizational skills
  • Detail-oriented with a high level of accuracy
  • Knowledge of medical coding structures
  • Insurance experience and industry knowledge
  • Thorough knowledge of self-funded benefit plans
  • Minimum of three years prior experience in a claims processing environment in a self-funded setting
  • Knowledge of Windows PC applications required (Microsoft Office preferred)
Submit Resume & Salary Requirements