Health Insurance Claims Specialist
5 days ago
We are seeking a highly organized and detail-oriented Claims Representative to join our team at Integrity Windows. As a Claims Representative, you will play a critical role in maintaining control of all mail delivered from the mailroom, ensuring timely and accurate processing of claims.
Key Responsibilities:- Handle all transmittal claims or inquiries received from the mailroom, or via fax or correspondence, researching and resolving all discrepancies.
- Responsible for adding all mail counts received by the mailroom into an access database.
- Distribute all claims to the appropriate areas by client if not in AWD.
- File all completed batches in Julian date order to be picked up for imaging when applicable.
- Place calls to providers to obtain correct mailing addresses.
- Obtain and turn in weekly supply list to the main office.
- Email or distribute outstanding and complete batch reports to area managers daily.
- Input previous days completed claim information into Daily Operation Statistic reports.
- Track daily claims receipts by claim type in excel spreadsheet, to be reported monthly.
- Handle claim batch maintenance for QicLink Support.
- Actively participate in cross training to maximize team efficiency and maintain or exceed service standards.
- Must understand the broad strategic concept of our business and link these to the day-to-day business functions of the mailroom, claim support, customer service and claim processing.
- Must be able to work scheduled shift and if needed, rotate schedules with other employees for proper departmental staffing needs and/or work overtime as needed.
- As needed, miscellaneous duties as assigned by team leaders, supervisors and management.
- Ability to understand mail batching process and display excellent research and filing skills when needed.
- Intermediate knowledge of Excel is essential.
- Must have a clear understanding of the business procedures within the claims and customer service areas.
- Good interpersonal and decision making skills required.
- Good written and oral communication skills with ability to speak effectively and clearly in person and over the phone.
- Must be organized and able to manage time effectively with all claim information from or to other departments.
- Good PC application skills and typing to 30 wpm with accuracy and clarity of content.
- Attention to detail and ability to listen / type simultaneously.
- Must be able to exhibit flexibility in performing multiple functions.
- Team centered with excellent work ethic and reliability.
- Honesty and respect for the company and its policies and procedures is required.
- High school diploma
- Must be local or residing in the nearby area
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