Health Claims Specialists

Excellent Internet Connectivity:

Internet access speed of 2 Mbps upload and 10 Mbps download – the faster the better.

house network, and a hard-wired internet connection capable of continuously supporting outstanding call quality and high-speed response rates.

(Wireless and/or satellite Internet Service Providers are

compatible with our systems)

Medical Billing and Coding degree/certification.

All your information will be kept confidential according to EEO guidelines.

#INDSP

EEOC and Veteran Documentation

During employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status.

At times, government agencies require periodic reports from employers on the sex, ethnicity, handicap, veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping, reporting, and other legal requirements. Periodic reports are made to the government on the following information. The completion of the Administrative EEO record is optional. If you choose to volunteer the requested information, please note that all

Administrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file.

What you will be doing as a Claims Examiner:

Be responsible for effectively adjudicating claims to meet production, quality, and other metrics in accordance with policy/procedures and regulatory guidelines

Follow up on claims needing additional information

Refer problem claims to a Lead and/or auditor for additional review

Work with specific software

Medical, dental, and vision plans.

This is a full-time permanent healthcare claims adjudicator position. A claims adjudicator determines how much money will be paid after an insurance claim has been examined. This is not a customer service or customer facing position. This is a data entry position where you will be processing medical claims per the specific client requirements. Claims can vary and are highly customized depending on the service level.  You will work independently with the assistance of knowledge base and support personnel. You will also be expected to meet all Key Performance Indicators and Quality goals throughout Training and beyond.