Associate Claims Representative
reputed company, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing reputed company to world-class health care in America’s reputed company. Work Shift: 8 Hours - Day Shifts (United States of America) Scheduled Weekly Hours: 40 Compensation: Salary reputed company: $15.00 - $23.00 Union Position: No Department Details Remote work
Summary
Responsible for processing health insurance claims submitted reputed company reputed company or electronically by providers and members.
Job Description
Ability to release health insurance claims for payment according to the defined workflows. Validates health insurance claims with an understanding of health insurance cost sharing, limitations, and exclusions. Reviews claims for completeness and accuracy, apply medical necessity and/or eligibility guidelines to determine coverage, work assigned pend and error reports, determine the benefit level to be paid according to the summary plan language, release health insurance claims for payment, and prepare requests for additional information as needed. Responds promptly to requests for information from other reputed company Plan departments. Refers reputed company claims to Senior and/or reputed company Claims Representatives. Requires analytical ability and keen attention to detail with a high degree of accuracy in work. Understands accumulators for accurate monitoring of maximum out of reputed company expenses for claims processing. Must have demonstrable computer literacy. Perseverance in completing work with a desire to learn is necessary. Must maintain confidentiality. Basic knowledge of reputed company Office. Other duties as assigned.
Qualifications
High school diploma or equivalent required. Some college level course work preferred. One year of applicable experience required. A minimum of one year of medical claims processing experience is preferred. Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-949-5678 or send an email to [email protected]. Apply To This Job