Claims Processor

3 weeks ago

Portland, Maine, United States CareFirst BlueCross BlueShield Full time
Job Summary:

As a Claims Processor at CareFirst BlueCross BlueShield, you will play a critical role in reviewing and adjudicating paper/electronic claims. Your attention to detail and analytical skills will ensure that claims are processed accurately and efficiently, following organizational policies and procedures.

Key Responsibilities:

Examine and resolve non-adjudicated claims to identify key elements of processing requirements based on contracts, policies, and procedures.
Process product or system-specific claims to ensure timely payments are generated and calculate deductibles and maximums, as well as research and resolve pending claims.
Utilize automated system processes to send pending claims, ensuring accurate completion according to medical policy, contracts, policies, and procedures, allowing timely considerations to be generated using multiple systems.

Requirements:

High School Diploma or GED.
Less than one year experience processing claim documents.
Demonstrated analytical skill, reading comprehension, and ability to follow directions provided.
Basic written/oral communication skills and ability to navigate computer applications.
Ability to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.

Salary Range:
$31,536 - $57,816

Equal Employment Opportunity:
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

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