Job Description

REMOTE (in approved states)
Arkansas, Florida, Georgia, Illinois, Kansas, Louisiana, Minnesota, Mississippi, Oklahoma, South Carolina, Tennessee, Texas, Virginia and Wisconsin.

Medical Claims or adjustments experience
Day to Day Systems used: Power, AMISYS, CWS, CCI, IOKB

The Claims Specialist resolves medical claims that are not automatically adjudicated by the claims processing system in a timely and accurate manner according to divisional standards of quality and productivity. Resolution may include additional investigation or communication in order to obtain necessary information to complete the claim. Outside issues such as peak filing season, systems down time, inclement weather, holidays, and absenteeism may directly affect the volume of work for each Specialist

Required Skills, Knowledge, and Experience:
Written and verbal communications
Strong Interpersonal skills
Sound Judgement
Decision Making
Detail-Oriented
Teamwork
Dependability

Required
OFFICE EXPERIENCE
CLAIMS
FILING
DETAIL-ORIENTED
CLAIMS PROCESSING

Additional
EXCELLENT WRITTEN AND VERBAL COMMUNICATION SKILLS
MEDICAL CLAIMS
OFFICE MEDICAL

Education:
High School diploma or equivalent. Two (2) years of college coursework (48 semester hours) or other equivalent certification with an emphasis in anatomy, medical terminology, math, biology, or a related field.
OR One (1) year of related office experience such as claims processing, health insurance, or medical office.

Must pass company proficiency test: Claims Assessment

Job Category: Customer Service