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Medicare Examiner II
3 months ago
Medicare Examiner II
Primary Duties & Responsibilities
At Globe Life, we are committed to empowering our employees with the support and opportunities they need to succeed at every stage of their career. Our thriving and dynamic community offers ample room for professional development, increased earning potential, and a secure work environment.
We take pride in fostering a caring and innovative culture that enables us to collectively grow and overcome challenges in a connected, collaborative, and mutually respectful environment that calls us to help Make Tomorrow Better.
Role Overview:
Could you be our next Medicare Examiner II? Globe Life is looking for a Medicare Examiner II to join the team
In this role, you will be responsible for supporting the claim operation by completing a wide variety of tasks designed to gather and organize claim information for processing by claim examiners. Key functions of this role vary as business needs dictate, but often include such tasks as mail sorting and preparation, claim indexing, customer contacts and check processing tasks. Additionally, the examiner will back up the refund desk by processing refunds, voids and managing the Subrogation queues.
This is a hybrid position located in McKinney, TX (WFH Monday & Friday, In Office Tuesday-Thursday).
What You Will Do:
- Review correspondence and Explanation of Benefits (EOBs) to verify reason for returned check (i.e. refund or reissue).
- Process refunds due to overpayments and ensure monies are credited to the appropriate account/company.
- Request additional information from provider required to accurately process refunds, as needed.
- Route checks needing to be reissued to appropriate examiner for processing.
- Identify non claim related checks and route to the appropriate business units (i.e. Unclaimed Property, Premium Accounting, Agency Services, etc.).
- Coordinate with General Accounting for verification of check status on void/stop payment requests.
- Respond to incoming inquires received through various channels (i.e. Customer Service, faxes, email, etc.).
- Maintain and ensure security of file cabinet with refund checks and other correspondence.
- Review daily On base reports to perform reconciliation of previous days refunds.
- Meet or occasionally exceed established standards for productivity and quality and maintain claim turnaround time set with accuracy less than 2% error ratio.
- Mail sorting, send letters, claim indexing, customer contacts and check processing tasks.
- Ensure all appropriate documentation , including any missing documentation is concise.
- Maintain LTC and Subrogation mailbox and responses.
- Attend and actively participate in departmental meetings, trainings and coaching sessions.
- Maintain patient privacy and confidentiality in accordance with HIPAA standards.
- All other duties as assigned or as a situation dictates.
What You Can Bring:
- High School Education.
- Health claims processing experience preferred.
- Ability to compile and review information to make sound decisions.
- Skilled in performing intermediate arithmetic calculations.
- Excellent typing skills.
- Proficiency in Microsoft Office Suite (i.e. Outlook, Excel, Word) and other basic computer programs.
- Ability to thrive in fast paced environment while working independently and with limited supervision.
- Positive team-oriented attitude with flexibility to adjust to changes as they arise.
- Ability to multi-task.
- High attention to detail and accuracy.
- Working knowledge of Onbase, and Mainframe.
Applicable To All Employees of Globe Life Family of Companies:
- Reliable and predictable attendance of your assigned shift.
- Ability to work full time and/or part time based on the position specifications.
How Globe Life Will Support You:
Looking to continue your career in an environment that values your contribution and invests in your growth? We've curated a benefits package that helps to ensure that you don’t just work, but thrive at Globe Life:
- Competitive compensation designed to reflect your expertise and contribution.
- Comprehensive health, dental, and vision insurance plans because we believe that taking care of your well-being is fundamental to your performance.
- Robust life insurance benefits and retirement plans, including company-matched 401k and pension plan.
- Wellness club reimbursements and gym discounts to help you stay on top of your health.
- Paid holidays and time off to support a healthy work-life balance.
- Parental leave to help our employees welcome their new additions.
- Development training programs to enhance your skills and career progression and unlock your full potential.
- Opportunity awaits Invest in your professional legacy, realize your path, and see the direct impact you can make in a workplace that celebrates and harnesses your unique talents and perspectives to their fullest potential. At Globe Life, your voice matters.
