Claims Processor, Intermediate
3 days ago
Your Role
The ITS Host Claims team processes claims and adjustments for out of state Blue Cross Blue Shield members that have services in California in a shared adjudication process. The Claims Processor Intermediate will report to the Operations Supervisor. In this role you will be responsible for reviewing and adjudicating claims and/or adjustments in accordance with provider contracts and organizational policies and procedures to meet operational, financial, and service requirements.
Your Knowledge and Experience
-
Requires a high school diploma or GED
Requires at least 3 years of experience
- Healthcare claims knowledge preferred, but not required
- Healthcare operations or customer service experience preferred
-
Requires good communication skills both written and verbally
Requires the ability to make and receive phone calls both internally and externally while providing excellent customer service.
-
Appeals and Grievances, Intermediate
2 weeks ago
Lodi, CA, United States Blue Shield of CA Full timeYour Role The Provider Dispute Resolution Team is looking for an Intermediate Provider Dispute Resolution Coordinator that can research, review and resolve high level/high priority provider grievances, appeals and complaints, while clarifying issues and educating providers in the process. The Intermediate Provider Dispute Coordinator will report to the...