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
Business Analyst

Position Summary

The Business Analyst is primarily accountable for accurate and timely adjustments to data and claims in the LuminX system. The analyst will be responsible for various special projects. 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 invoices.
  • Research and execute LuminX adjustments in an accurate and timely manner.
  • 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.
  • Resolve LuminX provider issues and update provider file data.
  • Assist other departments and team members as needed.
  • Perform miscellaneous projects.

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
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
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
Online Enrollment Technician

Position Summary

The Online Enrollment Technician is responsible for the setup and testing of new and renewing groups under the Dashboard Online Enrollment system. Setup includes coordination of benefit rules and payroll deduction information from the Account Executive. HR Connect implementation duties will include interaction with clients/brokers to obtain the documentation necessary for website availability and client training for HR Connect setup.

Responsibilities

  • Collect Online Enrollment Agreement (OLE) and review for completeness and options selected.
  • Depending on the OLE options selected, coordination may be necessary with the Large Group Manager to obtain benefit rule document, payroll deductions and confirm completion of the document library, benefit comparisons and the Summary Benefits and Coverage (SBC) as it will be displayed on the website.
  • Complete the setup of payroll maintenance screens, payroll deductions, website descriptions, and non-administered products.
  • Analyze employee census against benefit participants and coordinate processing of additional enrollment as necessary.
  • Reconcile website payroll deductions to actual payroll deductions when provided by the client.
  • If payroll differences are found, coordinate with the Large Group Manager for communication and resolution.
  • Review and approve setup before handoff to Large Group Manager for final approval when necessary.
  • Migration of current OLE clients to the dashboard.
  • Review daily reports and update benefit rules of dashboard groups at plan setup or renewal.
  • Collect the HR Connect Agreement and review for completeness.
  • Based on the HR Connect Agreement, setup HR Connect access, the company logo, and HR users.
  • Perform quality review of HR Connect setup.
  • Coordinate client training to setup Personnel Registrations, Managers, Departments, use of the dashboard to evaluate the status of job applicants and approval of the system.
  • Reconcile the Payroll Sync Report to ensure continuity between Genie and website.
  • 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

  • Applicant must possess strong skills in Excel including the ability to create formulas, pivot tables, vlookups, import/export files, etc.
  • Familiarity with Microsoft Outlook and Word.
  • Excellent written and oral communication skills required.
  • Must have strong interpersonal skills and work well in a team environment.
  • Detail-oriented with the ability to prioritize and analyze work.
  • General understanding of Employee Benefits and Payroll is desired.
  • Ability to accomplish heavy workload on a strict schedule and complete with at least 99% accuracy.
  • Strong analytical background and the ability to read contracts, benefit rules and confirm group structure.
Submit Resume & Salary Requirements