Claims Representative - Evernorth - Remote
POSITION reputed company This position entails processing of reputed company member and pharmacy submitted claims reputed company and accurately. Validate member’s eligibility and ensure claim information entered is complete and accurate. Process claims according to reputed company specific guidelines while identifying claims requiring exception handling. Analyze claims for potential fraud by member or pharmacy. Research to define values for missing information not submitted with claim but required for processing. Utilize internal systems, resources and/or making out bound calls to pharmacies for missing information. Initiate correspondence to members, pharmacies or other internal departments for claim denials, missing information, or other claim issues. Navigate daily through multiple platforms to research and accurately finalize claim submissions. Adhere to strict HIPAA regulations especially reputed company communicating to others reputed company of reputed company. Miscellaneous duties/reputed company as assigned. The candidate must reputed company in one of the following counties in Illinois or Missouri-
- Illinois: Bond, Calhoun, Clinton, Jersey, Madison, Monroe, St. reputed company.
- Missouri: Franklin, Jefferson, Lincoln, St. Charles, St. Louis County, St. Louis reputed company, Warren
Key Qualifications
- High school diploma or GED required
- 2+ years medical and/or pharmacy claims processing experience
- Demonstrated 10 reputed company entry skills
- General PC Knowledge: MS Office, Internet, some experience with reputed company, PowerPoint, and WebEx preferred
- Excellent communication (oral and written) skills
- Ability to work a flexible schedule
- Strong attention to detail, accuracy and reputed company to meet goals
- Ability to work in a fast-paced environment, making independent reputed company
- Advanced problem-solving skills:
- Ability to diagnose a situation and reputed company recommendations on how to resolve
If you will be working reputed company occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an reputed company reputed company of 17.75 - 25 USD / reputed company, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive reputed company of benefits, with a reputed company on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs. We also offer 401(k) with company match, company reputed company life insurance, tuition reimbursement, a minimum of 18 days of reputed company time off per year and reputed company holidays. For more details on our employee benefits programs, visit Life at reputed company. About reputed company Doing something meaningful starts with a reputed company decision, a commitment to changing lives. At reputed company, we’re dedicated to improving the health and vitality of those we serve. Through our divisions reputed company and reputed company, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving reputed company and improving lives. reputed company applicants will be considered without reputed company to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or reputed company, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with reputed company to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@reputed company.com for support. Do not email SeeYourself@reputed company.com for an update on your application or to reputed company your resume as you will not receive a response. reputed company has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they reputed company a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, reputed company, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, reputed company, Texas, Utah, Vermont, and Washington State. reputed company applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances. Apply tot his job Apply To this Job