Temporary Benefits Claims Advocate
Calvert County Government, Prince Frederick, MD, United States
Temporary Health Insurance Claims Coordinator
Performs specialized administrative and customer service work assisting employees with health insurance claims and coverage issues. The work involves coordinating with employees, medical providers, and insurance carriers to resolve claims discrepancies, ensure proper benefits application, and support accurate claims processing. This position is temporary and project-based, created to address increased workload during a system transition. Work is performed under general supervision.
Essential Job Functions Provides direct assistance to employees by receiving, reviewing, and documenting health insurance claims issues and concerns. Conducts research and analysis of claims discrepancies, including denials, billing errors, and eligibility issues.
Coordinates and participates in real-time communications between employees, medical providers, and insurance carrier representatives to resolve claims issues. Explains benefit plan provisions, including coverage rules and plan design, to ensure accurate billing and claims processing.
Monitors claims through the resolution process, ensuring corrections are completed and claims are properly reprocessed. Maintains detailed records of case activity, including actions taken, status updates, and final outcomes.
Prioritizes cases based on urgency and impact, including active treatment situations and high-cost claims. Follows up with stakeholders to ensure timely resolution.
Identifies trends and recurring issues in claims processing and communicates findings to Human Resources staff for further review or escalation. Coordinates with internal staff and external representatives to address unresolved or complex issues.
Provides responsive, high-touch customer service to employees by explaining processes, next steps, and expected timelines, and by reducing the burden on employees navigating benefits issues.
Performs related work as required.
Knowledge, Skills, and Abilities Knowledge of - Basic principles and practices of health insurance, including claims processing, billing procedures, deductibles, copayments, and plan design; customer service practices; and standard office procedures.
Ability to - Analyze and resolve claims and billing issues; communicate clearly and effectively both orally and in writing; explain technical information to non-technical individuals; manage multiple cases simultaneously; maintain accurate and detailed records; exercise sound judgment in handling sensitive or confidential information; establish and maintain effective working relationships with employees, providers, and insurance representatives; and remain effective in high-pressure or time-sensitive situations.
Required Qualifications Training and/or Education: High school diploma or GED equivalent.
Experience: Two (2) years of experience in employee benefits administration, health insurance claims, customer service, medical billing, or a related field.
Preferred Qualifications: Experience working with health insurance carriers, particularly CareFirst or Blue Cross Blue Shield; familiarity with self-insured health plans; and experience handling complex or high-volume casework.
Licenses or Certificates None required.
Special Requirements This is a temporary, limited-term position expected to last approximately 60 to 90 days depending on operational needs. Work schedule may require flexibility to coordinate with provider and carrier availability.
Physical Demands Work requires the operation of keyboard devices and extended periods of sitting, with occasional walking, standing, bending, or carrying of light objects.
Unusual Demands Work is subject to frequent interruptions, multiple concurrent assignments, and time-sensitive deadlines. The position involves regular interaction with individuals who may be frustrated or distressed due to benefits or billing issues.
FLSA Status Non-exempt
Compensation Steps:
Pay rate: $26.54 per hour
Grade 719, Temporary position, up to 35 hours per week
Department of Human Resources
Position closing date: May 5, 2026
Please Note: This position will close at 11:59 p.m. on May 5, 2026. To be considered for the role, ensure that your application is submitted before the deadline. The position will be removed from the website as of 12:00 a.m. on May 6th.
Please Note: A complete application is required to be considered for a position within Calvert County Government. All prior work experience, education, and other certifications should be entered into the application and supplemental questions should be answered completely. Attachments are not provided to hiring managers unless you are selected for an interview.
Calvert County Government is committed to providing equal opportunity and reasonable accommodations for qualified individuals with disabilities. If you require an accommodation to participate in the application or interview process, please contact Human Resources at recruitment@calvertcountymd.gov with as much notice as possible.
Performs specialized administrative and customer service work assisting employees with health insurance claims and coverage issues. The work involves coordinating with employees, medical providers, and insurance carriers to resolve claims discrepancies, ensure proper benefits application, and support accurate claims processing. This position is temporary and project-based, created to address increased workload during a system transition. Work is performed under general supervision.
Essential Job Functions Provides direct assistance to employees by receiving, reviewing, and documenting health insurance claims issues and concerns. Conducts research and analysis of claims discrepancies, including denials, billing errors, and eligibility issues.
Coordinates and participates in real-time communications between employees, medical providers, and insurance carrier representatives to resolve claims issues. Explains benefit plan provisions, including coverage rules and plan design, to ensure accurate billing and claims processing.
Monitors claims through the resolution process, ensuring corrections are completed and claims are properly reprocessed. Maintains detailed records of case activity, including actions taken, status updates, and final outcomes.
Prioritizes cases based on urgency and impact, including active treatment situations and high-cost claims. Follows up with stakeholders to ensure timely resolution.
Identifies trends and recurring issues in claims processing and communicates findings to Human Resources staff for further review or escalation. Coordinates with internal staff and external representatives to address unresolved or complex issues.
Provides responsive, high-touch customer service to employees by explaining processes, next steps, and expected timelines, and by reducing the burden on employees navigating benefits issues.
Performs related work as required.
Knowledge, Skills, and Abilities Knowledge of - Basic principles and practices of health insurance, including claims processing, billing procedures, deductibles, copayments, and plan design; customer service practices; and standard office procedures.
Ability to - Analyze and resolve claims and billing issues; communicate clearly and effectively both orally and in writing; explain technical information to non-technical individuals; manage multiple cases simultaneously; maintain accurate and detailed records; exercise sound judgment in handling sensitive or confidential information; establish and maintain effective working relationships with employees, providers, and insurance representatives; and remain effective in high-pressure or time-sensitive situations.
Required Qualifications Training and/or Education: High school diploma or GED equivalent.
Experience: Two (2) years of experience in employee benefits administration, health insurance claims, customer service, medical billing, or a related field.
Preferred Qualifications: Experience working with health insurance carriers, particularly CareFirst or Blue Cross Blue Shield; familiarity with self-insured health plans; and experience handling complex or high-volume casework.
Licenses or Certificates None required.
Special Requirements This is a temporary, limited-term position expected to last approximately 60 to 90 days depending on operational needs. Work schedule may require flexibility to coordinate with provider and carrier availability.
Physical Demands Work requires the operation of keyboard devices and extended periods of sitting, with occasional walking, standing, bending, or carrying of light objects.
Unusual Demands Work is subject to frequent interruptions, multiple concurrent assignments, and time-sensitive deadlines. The position involves regular interaction with individuals who may be frustrated or distressed due to benefits or billing issues.
FLSA Status Non-exempt
Compensation Steps:
Pay rate: $26.54 per hour
Grade 719, Temporary position, up to 35 hours per week
Department of Human Resources
Position closing date: May 5, 2026
Please Note: This position will close at 11:59 p.m. on May 5, 2026. To be considered for the role, ensure that your application is submitted before the deadline. The position will be removed from the website as of 12:00 a.m. on May 6th.
Please Note: A complete application is required to be considered for a position within Calvert County Government. All prior work experience, education, and other certifications should be entered into the application and supplemental questions should be answered completely. Attachments are not provided to hiring managers unless you are selected for an interview.
Calvert County Government is committed to providing equal opportunity and reasonable accommodations for qualified individuals with disabilities. If you require an accommodation to participate in the application or interview process, please contact Human Resources at recruitment@calvertcountymd.gov with as much notice as possible.