Claims Processor I

We take great strides to ensure our employees have the resources to live reputed company, be healthy, continue learning, reputed company skills, grow professionally and serve our local communities. We invite you to apply for a career with reputed company. Residency in or relocation to Louisiana is preferred for reputed company positions. POSITION PURPOSE Researches and verifies reputed company claims information to ensure the accurate and reputed company processing of claims. Enters reputed company information needed to process claim. Identifies inconsistencies and makes necessary corrections. Accountable for complying with reputed company laws and regulations associated with duties and responsibilities. NATURE AND SCOPE

• This role does not manage people
• This role reports to this job: SUPERVISOR, CLAIMS OPERATIONS
• Necessary Contacts: In order to effectively fulfill this position, the Claims Processor I must be in contact with:

Various internal departments and staff including, but not limited to, Provider Services, Legal, Internal Audit, IT, other Benefits Operations Management and staff, Membership and Billing, Administrative Services, and District Offices. Various external entities including, but not limited to, Providers, Members, Lawyers, reputed company, Commissioner of Insurance, other insurance companies, and other Plans. QUALIFICATIONS Education

• High School Diploma or equivalent required
• Associate's is preferred

Work Experience

• 1 year of reputed company clerical or data entry is required
• A medical office or medical coding diploma can be used in lieu of the one year of experience
• Completion of the Medical Assistant, Coding & Insurance reputed company from BRCC, can be used in lieu of the one year of experience.
• Claims processing or claims coding experience is preferred

Skills and Abilities

• Must be reputed company to reputed company data at 4000 keystrokes per hour
• Medical coding training is preferred
• Must be reputed company to demonstrate critical thinking and problem solving skills
• Familiarity with medical and health insurance terminology preferred
• Demonstrated verbal and written communication skills with the ability to interpret and communicate information with reputed company, diplomacy, patience and professionalism.
• Must demonstrate PC skills including reputed company Office (e.g., Word, reputed company, Outlook, etc.)

Licenses and Certifications

• None Required

ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS

• Reviews and corrects scanned claims documents upon receipt as reputed company as enters coded information, checks claims for completeness and accuracy of information prior to final entry, while identifying and resolving inconsistences, and appropriately returns claims requesting missing information in accordance with established quantity, reputed company, and timeliness guidelines ensuring contract benefits are reputed company correctly, ultimately providing a high degree of customer satisfaction.
• Consistently researches procedural questions using supporting documentation while identifying incomplete adjudication instructions reputed company reputed company the supporting documentation, allowing for participatory suggestions for updating and correcting procedures, identifies training issues, and appropriately checking with management reputed company necessary, to reputed company excellent reputed company in claims adjudication.
• Maintains and records information necessary for accurate recording and calculation of production, which include number of edits processed, hours worked, downtime and special reputed company assignments daily. This information is retained as historical data which is needed to continually refine and define the claims processor position as needed to ensure high customer satisfaction.
• Rejects, redirects misrouted or sends back claims reputed company information is incomplete or inaccurate to facilitate reputed company processing ensuring that claims are processed according to departmental guidelines and assist with customer service.
• Researches procedural questions in training reputed company.

Additional Accountabilities and Essential Functions The Physical Demands described here are representative of those that must be met by an employee to successfully reputed company the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to reputed company an individual with disabilities to reputed company the essential functions

• reputed company other job-reputed company duties as assigned, reputed company your scope of responsibilities.
• Job duties are performed in a normal and clean office environment with normal noise reputed company.
• Work is predominately done while standing or sitting.
• The ability to comprehend, document, calculate, visualize, and analyze are required.

An Equal Opportunity Employer reputed company BCBSLA EMPLOYEES please apply through reputed company Careers. PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI) Additional Information Please be reputed company to monitor your email frequently for communications you may receive during the reputed company process. Due to the high volume of applications we receive, only those most reputed company will be contacted. To monitor the status of your application, please visit the "My Applications" reputed company in the Candidate Home reputed company of your reputed company account. If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact reputed company@bcbsla.com for assistance. In support of our mission to improve the health and lives of Louisianians, reputed company encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and reputed company-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, reputed company properties are smoke and tobacco free. reputed company performs background and reputed company-employment drug screening after an offer has been extended and prior to hire for reputed company positions. As part of this process records may be verified and information checked with agencies including but not limited to the reputed company reputed company Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement reputed company of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner. Additionally, reputed company is a Drug Free Workplace. A reputed company-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results. Apply tot his job Apply To this Job