Claims Examiner

1 month ago

Topeka, United States BCforward Full time

Claims Examiner

BCforward is currently seeking a highly motivated Claims Examiner in Topeka KS.

Position Title: Claims Examiner

Location: Topeka KS 66619

Anticipated Start Date: Tentative start Date 08/19/2024
Please note this is the target date and is subject to change. BCforward will send official notice ahead of a confirmed start date.

Expected Duration: 12+ months Contract with a strong possibility of extension

Job Type: Contract (40 HRS WEEKLY), [CONTRACT], [Hybrid after Training]

Pay Range: $23/hr - $24/hr
Please note that actual compensation may vary within this range due to factors such as location, experience, and job responsibilities, and does not encompass additional non-standard compensation (e.g., benefits, paid time off, per diem, etc.).

Requirements:
Medical Claims, Insurance Specialist, Paralegal

Job Description:

  • Interact professionally (i.e. on incoming and outgoing calls) with attorneys, insurance adjusters, medical providers, court staff, recipients family members, and clients.
  • Effectively maintain and manage a variety of cases with current and accurate notes from creation to recovery
  • Maintain a daily system of providing timely and accurate information required to move cases through the case management workflow.
  • Daily telephone contact with counterparties, including attorneys, adjusters, and healthcare providers
  • Independently work cases of high dollar value up to and through settlement
  • Confirm and validate third-party liability and, probate and beneficiary asset research.
  • Prepare required correspondence, liens, claims, and other related documents to progress the case to recovery.
  • Negotiate and compromise claim/ lien settlement amounts per contract guidelines.
  • Process all claim/ lien disputes and review claims with attorneys and other stakeholders.
  • Conduct outgoing follow-ups on case status and payment.
  • Perform basic and advanced levels of document review to identify current case status, legal research, and case management and ensure case progress through workflow.
  • Prioritize case events and critical case payment/ recovery issues, while meeting, various internal and legal deadlines that are revenue-impacting.
  • Compile, analyze, and make conclusions about case information and status from multiple sources.
  • May serve as an escalation point for the assistant claims examiner
Non-Essential Responsibilities:
  • Performs other functions as assigned
  • Knowledge, Skills, and Abilities
  • Ability to interact with all levels of people both internally and externally in a professional manner.
  • Ability to be careful and thorough about detail including cite-checking and proof-reading skills.
  • Ability to multi-task and prioritize effectively.
  • Ability to work proficiently with Microsoft Office, PowerPoint, Word, and Excel required
  • Ability to work independently to meet objectives.
  • Ability to analyze information and use logic to address work-related issues and problems.
  • Ability to perform well in a team environment, to achieve business goals.
  • Ability to maintain a high level of confidentiality and ethics.
  • Ability to handle pressure and manage deadline-oriented project demands and multiple initiatives.
Work Conditions and Physical Demands:
  • Primarily sedentary work in a general office environment
  • Ability to communicate and exchange information
  • Ability to comprehend and interpret documents and data
  • Requires occasional standing, walking, lifting, and moving objects (up to 30 lbs.)
  • Requires manual dexterity to use computer, telephone, and peripherals
  • May be required to work extended hours for special business needs
  • May be required to travel at least 10% of the time based on business needs
Minimum Education:
  • High School Degree
Certifications (Required/Desired):
  • A paralegal certificate is desired but not necessary
Minimum Related Work Experience:
  • Experience in a Legal office a plus; paralegal or legal assistant and/or experience in the insurance
  • industry (casualty or health insurance) a plus
  • Knowledge of Microsoft Word and Excel is required.
  • Basic knowledge of Microsoft Access is preferred.
  • Medicaid and/or Medicare knowledge preferred.
  • Bilingual (Spanish & English) a plus.

Keywords:
Claims Examiner, Insurance Specialist, Paralegal, Claims Auditor,

Who to Contact: Priyanka Samindla

About BCforward:
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward' s 6,000 consultants support more than 225 clients globally.
BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best-in-class place to work.
BCforward is an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.
To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.
This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at will regardless of the anticipated assignment duration.

Interested candidates please send resume in Word format Please reference job code 225412 when responding to this ad.

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