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Claims Processing Coordinator

2 months ago

Richardson, Texas, United States Health Care Service Corporation Full time

About Health Care Service Corporation (HCSC)

At HCSC, our workforce is the backbone of our organization and the key to our achievements. We equip our employees with tailored development strategies that encourage advancement and foster rewarding, meaningful careers.

Position Overview

This role is pivotal in managing the administrative setup of claims and conducting initial assessments, which encompass verifying eligibility, determining coverage limits, understanding policy requirements, and coordinating with group contacts and payment protocols. The position also involves updating member information within billing systems and addressing inquiries from both internal and external stakeholders promptly.

Key Responsibilities:
- Execute administrative claim setup and initial claim evaluations
- Ensure accuracy in member data within billing systems
- Respond efficiently to inquiries from customers and colleagues

Essential Qualifications:
* High School Diploma or GED with a minimum of 3 years of claims experience, or a Bachelor’s degree with at least 1 year of claims experience
* Proven customer service skills
* Strong organizational abilities
* Capacity to manage multiple tasks simultaneously
* Familiarity with state regulations, statutes, and ERISA
* Excellent verbal and written communication skills
* Proficiency in Microsoft Word, Excel, PowerPoint, and Lotus Notes

Preferred Qualifications:
* Experience with ECM, STAR (Claims System), Genelco/GIAS, Siebel, UTS, Casetrak, Docsql, Benefits Manager, ImagePlus, and Index Assist Tool
* Strong mathematical aptitude and critical thinking skills
* Detail-oriented approach to work

Work Arrangement:
This is a flexible position requiring 3 days in the office and 2 days working remotely.

Equal Opportunity Employment Statement:
HCSC is committed to creating an inclusive workplace where the unique differences of our employees are embraced, respected, and valued. All qualified candidates will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Compensation:
Base Pay Range: $27.15