Job is Expired
Location: Alabama, Arizona, Connecticut, Florida, Georgia, Indiana, Iowa, Kansas, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wyoming
Compensation: To Be Discussed
Staff Reviewed: Mon, Jul 18, 2022
Job Summary
A health insurance company is in need of a Remote Health Insurance Claims Support Group Senior Claims Examiner.
Core Responsibilities Include:
- Reviewing and investigating claims and encounters for medical, facility, pharmacy, dental and vision services
- Auditing and handling of specific claims and appeal requests
- Identifying defects and improving departmental performance by supporting quality, operational efficiency and production goals
Qualifications Include:
- High School Diploma or GED from an accredited institution
- Experience identifying root cause claims adjudication process failures and ability to quantify departmental impact
- Experience with the investigation, determination and reporting of claims processes\
- Experience working with Excel spreadsheets
- Experience standardizing reports across multiple sheets, utilizing VLOOKUPs & functions/formulas, creating, using/interpreting pivot tables, etc
- Experience handling Personal Health Information (PHI) in a professional manner
