Job Title : WFH Claims Processor
Position Type : 11+ Months
Location : Remote
Job Description
- Pay or deny claims according to the benefit summary
- Review membership eligibility for determination
- Assign correct provider for proper payment
- Follow all HIPA guidelines
- Review member’s out of pocket for correct cost share application
- Review COB information and apply it accordingly
- Review Error codes, warning messages and edits for correct processing
- Analyze claims for correct payment verification and adjust where needed
- Use of the Facets system to adjudicate claims
Preferred experience :
- Priority will be given to those with knowledge of the QNXT systems and application
- Knowledge of Medicaid, Medicare or commercial claims processing
- COB and benefit summary knowledge
Required :
- High school diploma or GED
- Experience with claims or customer service in medical field
- Ability to work independently and with others in a fast pace production based environment
- Basic Excel skills
Regards,
Companies across U.S. have engaged ReqRoute, Inc to deliver skilled, dedicated IT professionals. Recruiting is our passion and we support Fortune 1000 companies with their hiring needs.
We always seek to deliver competitive and sought-after career opportunities to our potential consultants and employees. We invite you to review the position requirements and apply today if your skills match our needs.
ReqRoute, Inc is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, national origin or any other characteristic protected under federal, state, or applicable local law. ()
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