Company in Uniontown is hiring a Medical Claims Examiner to join the team!
Pay Range: $33,000 - $35,000
Standard hours are Monday - Friday 7:00 am to 4:00 pm - but there is some flexibility to these hours (i.e. could be 7:30 - 4:00 or 7:30 - 4:30, or 8:00 - 5:00)
1 Receive incoming calls regarding insurance coverage and benefits, eligibility issues along with claim status.
2 Answer and return phone calls and emails from Client members. Return voice mail messages in accordance with organizational standards.
3 Accurately process medical / dental claims according to plan provisions, corporate policies and procedures.
4 Consistently meet production goals in accordance with organizational standards
5 Communicate systems issues promptly to the Claims Supervisor/Manager
6 Responsible for the management of all telephone calls and general correspondence received from members of our Client’s health plan
7 Demonstrate a positive and cooperative work attitude, encourage teamwork among fellow employees and customers.
8 Provide backup in other areas, based on business need, assisting management with special projects or requests. Additional tasks as assigned by management.
1 Able to serve medical insurance plan members and medical providers by determining insurance coverage including eligibility and claim status; examining and resolving medical claims
2 Must have above average knowledge with claims adjustment / processing, financial software, documentation skills, data entry, analyzing information, problem solving, verbal and written communication, customer focus, general math skills and statistical analysis. Must be able to work independently, be organized and have the ability to multi-task.
EDUCATION and/or EXPERIENCE:
Associates Degree with a minimum of three (3) years recent experience in processing medical claims required.