Claims Representative I

2 days ago


Columbus, Ohio, United States Elevance Health Full time
{"Job Title": "Claims Representative I", "Job Summary": "We are seeking a skilled Claims Representative I to join our team at Elevance Health. As a Claims Representative I, you will be responsible for processing claims, researching and analyzing claims issues, and manually calculating benefit determinations. You will work under direct supervision and rely on others for instruction, guidance, and direction.

Responsibilities:

* Process claims forms for payment, ensuring all information is supplied before eligible payments are made.
* Research and analyze claims issues, referring to policy overage and benefit limitations information to determine the appropriate course of action.
* Manually calculate benefit determinations, including non-payable categories, savings, and payments.
* Re-enter claims using the PAC (pre-adjudication correction) process for original and reopened claims to be adjusted.

Requirements:

* High school diploma or equivalent and related experience.
* Good oral and written communication skills, previous experience using PC, database system, and related software.
* Ability to work from home with hard-wired internet access and a quiet and private workspace.
* Familiarity with basic arithmetic computations and data entry.
* Knowledge of medical terminology and codes.

What We Offer:

* Market-competitive total rewards, including merit increases, paid holidays, and incentive bonus programs.
* Medical, dental, vision, short and long-term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs, and financial education resources.
* Hybrid Workforce Strategy, with the opportunity to work from home and in the office.

Join Elevance Health, a health company dedicated to improving lives and communities. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes, and drive our shared success - for our consumers, our associates, our communities, and our business.

We are an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status or condition protected by applicable federal, state, or local laws.

If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state, and local laws.

Applicants who require accommodation to participate in the job application process may contact us for assistance.

We look forward to hearing from you

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