Health Claims Processor

2 weeks ago


Marquand, Missouri, United States Elevance Health Full time
Job Summary

Elevance Health is seeking a skilled Claims Resolution Specialist to join our team. As a Claims Resolution Specialist, you will be responsible for processing health claims in accordance with claims policies and procedures.

Key Responsibilities
  • Key health claims in accordance with claims policies and procedures.
  • Process claims with a good understanding of benefit contracts, pricing, processing, policies, procedures, government regulations, coordination of benefits, healthcare terminology, and adjust claims.
  • Review, analyze, and process claims/policies related to events to determine the extent of the company's liability and entitlement.
  • Research and analyze claims issues.
  • Respond to inquiries, may involve customer/client contact.
Requirements
  • High School diploma or equivalent and a minimum of 1 year of claims processing experience.
  • Previous experience using PC, database system, and related software (word processing, spreadsheets, etc.).
  • Any combination of education and experience which would provide an equivalent background.
Preferred Skills
  • FHPS experience.


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