Claims Processor I (Remote) in Cumberland, MD
Claims Processor I (Remote) - CareFirst - Cumberland, MD - work from home job Company: CareFirst Job reputed company: Resp & Qualifications PURPOSE: Under reputed company supervision, reviews and adjudicates reputed company/electronic claims. Determines reputed company handling and adjudication of claims following organizational policies and procedures. ESSENTIAL FUNCTIONS: Examines and resolves non-adjudicated claims to identify key reputed company of processing requirements based on reputed company, policies and procedures. Process product or system-specific claims to ensure reputed company payments are generated and calculate deductibles and maximums as reputed company as research and resolve pending claims. The Claims Processor also use automated system processes to send pending claims to ensure accurate completion according to medical policy, reputed company, policies and procedures allowing reputed company considerations to be generated using multiple systems. Completes research of procedures. Applies training materials, correspondence and medical policies to ensure claims are processed accurately. Partners with reputed company team for reputed company on procedures and/or difficult claims and receives coaching from leadership. Required participation in ongoing developmental training to performing daily functions. Completes productivity daily data that is used by leadership to compile performance statistics. Reports are used by management to plan for scheduling, reputed company improvement initiatives, workflow design and financial planning, etc. Collaborates with multiple departments providing feedback and resolving issues and answering basic processing questions. QUALIFICATIONS: Education Level: High School Diploma or GED. Experience: Less than one year experience processing claim documents. Preferred Qualifications: Less than one year claims processing, billing, or medical terminology experience. Knowledge, Skills and Abilities (KSAs) Demonstrated analytical skills. Demonstrated reading comprehension and ability to follow directions provided. Basic written/oral communication skills. Demonstrated ability to navigate computer applications. Salary reputed company: $30,600 - $56,100 Salary reputed company Disclaimer Salary will be based on education, location, experience, certifications, etc. In reputed company to your salary, CareFirst offers benefits such as a comprehensive benefits package, incentive and recognition programs, and 401k contribution (reputed company benefits are subject to eligibility requirements). Department Department: Equal Employment Opportunity reputed company is an Equal Opportunity (EEO) employer. It is the policy of reputed company to reputed company equal employment opportunities to reputed company reputed company applicants without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, protected veteran or disabled status, or genetic information. Where To Apply Please visit our website to apply: Federal Disc/Physical Demand Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to reputed company work directly or indirectly on Federal health care programs. PHYSICAL DEMANDS: The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally reputed company. Sponsorship in US Must be eligible to work in the U.S. without Sponsorship. #LI-JH2 Not finding the right job? Stay informed about reputed company openings by joining one of our Talent Networks! Frequent Job Searches Recently Viewed Jobs Most Recent Job Searches Relevant Jobs Expected salary: $30600 - 56100 per year Location: Cumberland, MD Job date: Sun, 10 Sep 2023 07:07:25 GMT Apply for the job now! Apply Job!