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Claims Processing Specialist I
2 months ago
Position Summary:
This role entails the meticulous entry of medical claim data into various databases, ensuring accuracy and timeliness. The Claims Coordinator is tasked with verifying claims scanned into specific categories, including Anesthesia, COB, and Special batches. Each claim in the batch will undergo verification, with the system prompting the verifier to audit specific fields for precision and completeness.
Compensation:
The anticipated salary range for this position is between $35,360.00 and $52,000.00 annually, which equates to an hourly rate of $17.00 to $25.00. The offered base pay may be adjusted based on individual factors such as education, certifications, skills, and experience. We prioritize exceptional talent and aim to provide competitive compensation packages tailored to attract and retain top candidates.
Key Responsibilities:
- Mail Processing: Receive and sort claims along with supporting documents in accordance with company policies.
- Information Verification: Identify claims that lack necessary information.
- Document Management: Scan, track, and log all daily mail following departmental guidelines.
- Data Entry: Input and maintain accurate records of all incoming and outgoing documents, including claims and applications.
- Timeliness Standards: Consistently meet internal and external deadlines for claim processing to ensure efficient service delivery.
- Compliance: Adhere to established production and quality standards, ensuring accuracy in claim processing.
- Independent Work: Manage assigned tasks autonomously, demonstrating accountability.
- Error Management: Ensure accurate denial processing for claims deemed inappropriate for payment.
- Numerical Skills: Perform basic arithmetic operations and detect errors.
- Additional Duties: Undertake other related responsibilities as assigned.
Qualifications:
- Strong attention to detail, organizational, and communication skills.
- High School diploma or equivalent.
- Familiarity with professional and institutional claim processing procedures, including COB and TPL.
- Experience with high-volume data entry.
- Basic understanding of claims processes and workflows.
- Proficient in office equipment and software, including MS Excel, Word, and Outlook.
- Typing speed of 60 Words per Minute (WPM) or 10,000 Keystrokes per Hour (KSPH).
- Preferred: Minimum of one year of practical experience or completion of an accredited vocational program in medical office or billing.
- Ability to work both independently and collaboratively in a fast-paced environment.
Other Requirements:
- Valid driver's license.
- Proof of state-required auto liability insurance.
