As a Medical Claims Processor, you will be responsible for:
Reviewing and processing medical claims accurately and thoroughly according to the benefits and eligibility guidelines.
Pay, pend or deny based on established claims processing criteria.
Request additional information as needed.
Refer claims to supervisor for review. .
Refer to internal administrative processing guidelines as a resource when processing.
Work Inbox daily to ensure claims issues are handled timely.
Special projects as assigned.
Ability to juggle and prioritize workloads, have strong analytical skills and demonstrate an understanding of the importance of accurate and timely work.
Excellent interpersonal and communication skills both written and verbal, demonstrated by the ability to: listen to and empathize with others and convey confidence.
You deliver customer support like you expect to receive it; with excellence.
Strong attention to detail with excellent problem solving skills.
Intermediate proficiency in Excel and Word, and ability to learn, understand and use multiple computer applications
One year medical claims processing experience. Understand benefits and eligibility