Claims Clerk Ii Job Description Sample
Claims Clerk II
About the Position: We are currently seeking a dynamic Claims Clerk II to join our team at our office in Latham, New York.
The Claims Clerk II provides clerical and administrative support to the Claims Processing Units. Position
Maintain daily, weekly, monthly, and yearly production/quality spreadsheets.
Provide clerical support, including, but not limited to, sorting, filing, distribution of work, copy and other clerical functions to support business needs. Update/maintain data bases and prepare reports as needed. Contribute to a team environment by consistently exhibiting excellent interpersonal skills and demonstrating flexibility with daily operations/function.
Perform other job related duties as dictated by business needs, as determined by management Position
Education: A high school/GED diploma is required. Relevant Work Experience:
Six months of administrative experience is preferred. Knowledge, Skills & Abilities: Basic Computer Skills Intermediate knowledge of MS Office, MS Word and MS Excel To Apply:
Click below on "Apply for this Position" to create a profile and apply for the position Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled Job Requirements SDL2017
Claims Clerk II
Excellence In Everything We Touch Position Summary Under direct supervision, performs a variety of claim clerical support duties for the Claim Department Responsibilities Receives and matches mail to the appropriate claim file through the various Service Center or Claim Office data systems. Creates claim file by inputting initial loss report information into the various data systems; completes and distributes paper file to the appropriate claim area.
Types a variety of material such as letters, reports, form letters, or memorandums from handwritten copy, typed copy or transcribing equipment by use of a typewriter, personal computer, word processor or an automated system. Proofreads work for accuracy; distributes all letters and memorandums for proper signatures before mailing. Performs a variety of clerical duties such as answering telephones, taking messages, and sorting and filing mail and correspondence, and data entry.
Determines proper file and claim number on unidentified claim correspondence by use of the various Service Center or Claim Office data systems. Responds to insureds and agents to complete general loss report information and may respond to the more routine claim questions from insureds and agents. Contacts agents and insureds on routine claims to obtain coverage information or to clarify coverage information supplied on a loss report.
Removes System form letters from printer and distributes to sender for signature before mailing. Operates equipment such as copiers; obtains and distributes copies as requested. Prepares outgoing mail which includes the sorting and stuffing of envelopes.
May assist in operating the check signing machine and in posting and distributing of claim checks issued. Assists in maintaining office supplies and forms; completes requisitions and orders supplies as needed. Assists in updating claim manuals.
May assist in typing and processing payments for approved billings and expenses. Keeps supervisor informed verbally and in writing of activities and problems within assigned area of responsibility; refers matters beyond limits of authority and expertise to supervisor for direction. Performs other related duties as required or requested.
Requirements Education equivalent to graduation from high school supplemented by courses in typing and personal computer skills or the equivalent in related work experience. Nine or more months experience as a Claim Clerk or the equivalent demonstrating a basic knowledge of computer entry and operations. Demonstrates good working knowledge of Claim processing and of Claim policies and procedures.
About Us Broadspire (www.choosebroadspire.com), a leading international third party administrator, provides risk management solutions designed to help clients improve their financial results. Broadspire offers casualty claim and medical management services to assist large organizations in achieving their unique goals, increasing employee productivity and reducing the cost of risk through professional expertise, technology and data analytics. As a Crawford Company, Broadspire is based Atlanta, Ga., with 85 locations throughout the United States.
Services are offered by Crawford & Company under the Broadspire brand in Europe (www.Broadspire.eu), including the United Kingdom (www.BroadspireTPA.co.uk). In addition to a competitive salary, Crawford offers you: Career advancement potential locally, nationally and internationally. Crawford & Company has more than 700 locations in 70 countries; On-going training opportunities through every stage of your career Strong benefits package including matching 401k; health, dental, and life insurance; employee stock purchase plans; tuition reimbursement and so much more.
Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford.
No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means. SDL2017
Sales Order And Claims Clerk
Sales Order and Claims Clerk (Quality Assurance)
Responsible for ensuring all orders meet established standards producing accurate Sales Orders and Claims.
DUTIES AND RESPONSIBILITIES
- Process approved Sales Orders to the Warehouse and Pharmacy respectively
- Drug Card adjudications processed within Pharmacy Benefit Management and Company guidelines
- Maintain error logs as assigned
- Charge credit cards on all approved claims
- Process Sales Orders scheduled for shipment by following Company Medical Supplies guidelines
- Plan and organize work effectively and ensure its completion
- Routinely provides feedback that increases efficiencies and decreases errors
- Ability to work independently under pressure and in the absence of the Quality Assurance Manager
- Maintain regular, predictable, consistent attendance and flexibility to meet the needs of the department Including overtime when needed at the Manager of Quality Assurance's discretion to keep the department on current date tasks
- Display a high level of adaptability, flexibility to change, and a high level of attention to detail
- Ability to prioritize workload of department and instill urgency in others so deadlines are met
- Due to access to sensitive information, maintain a high degree of confidentiality at all times
- Represent the organization and department professionally at all times
- All other duties and responsibilities that may be assigned
- High School Graduate or equivalent
- 1-3 years’ experience required
- Professional Certification preferred
- Tech School/Associate Degree preferred
This is a temp to hire opportunity
PrideStaff is honored to have earned the prestigious Best of Staffing Diamond Award. Less than 2% of all staffing agencies in North America receive the Best of Staffing Award for service excellence and only 18% have gone on to earn the Diamond Award for service excellence. In addition, PrideStaff is the only commercial staffing firm in the U.S. and Canada with over $100 million in revenue to earn the Diamond Award for two years in a row, highlighting exceptional client and talent service quality.
Our Mission: Consistently provide client experiences focused on what they value most.
Claims Appeals Clerk
Morgan Stephens represents the nation’s top healthcare systems offering the highest compensation and benefits to our top candidates. We are created and managed by experienced industry professionals in healthcare. As a leading provider of contract, contract to perm, and direct placement recruiting services to healthcare organizations throughout the United States, we have successfully served the needs of our employees and clients by placing thousands of quality healthcare professionals into organizations seeking top talent.
Exciting opportunity for career growth for a healthcare administrative professionals with any background in claims!
Details: printing letters, printing envelops, getting them stamped, making copies of the letter, and creating files for member compliance and appeals. Putting information into the system for documentation purposes and completing jobs that have a deadline.
Attention to detail
Ability to meet deadlines and work under pressure
Strong communication skills.
Professional clerical experience or data entry experience
35+ WPM score
Morgan Stephens ofrecemos reclutadores que hablan Espanol
Warranty Claims Clerk
MPP Company, as a leader in the industry, provides a comprehensive selection of extended warranty services and other automotive protection plans designed to give our customers the best buying and ownership experience. We provide vehicle service contracts (frequesntly referred to as extended warranties), maintenance contracts, paintless dent repair, lease wear coverage and more.
Receive documents in from dealers and customers
Check email folders on a regular basis for incoming documents to import into scanning software
Index documents to the correct department for processing
Contact customers / dealerships concerning payable issues
Other duties may be assigned
Strong keyboard skills including 10 key
Minimum high school diploma or GED equivalent required
Excellent customer service skills, underwriting background a plus
Ability to be analytical and multi-task
Ability to work with little supervision
Self-motivated, enthusiastic presence in a team environment
Strong written and communication skills
Working knowledge of Microsoft Office
Consistent and stable work history
Valid driver's license and clean driving record
Professional appearance and work ethic
- All potential employees must pass pre-employment testing to include a background check and drug screen. BENEFITS:
Competitive earning and overtime potential
Fast paced work environment
Paid training and development
Career growth opportunities with management potential
Medical and dental coverage available 2 month period
401(k) Company location: 8500 Shawnee Mission Parkway Merriam, KS 66202 Compensation: $14 - 15/ HR External Company Name: Berkshire Hathaway Automotive External Company URL: www.vantuylgroup.com
Flood Insurance Claims Clerk
Summary Thisindividual will be responsible for handling Flood Insurance processing issuesfor DXC. Employees will be processing checks, support answering inquires whileadhering to procedures.
Experience in Home Owners or P&C or Flood Insurance or HealthInsurance is a plus
Will be responsible for handling complex billing issues and Checkprocessing
Experience in Insurance Billing is preferred
Must be extremely organized
High analytical skills with the ability to thinkcritically to solve complex issues
Proficient in time management skills and comfortablewith tight deadlines
Strongcomputer skills: MS Office (Excel, Word, Outlook)
Conducts correspondence related to clientrequests for information.
Evaluates available information to validateclaims. Verifies policyholder information, policy effective dates, premiumstatus and verification of claim eligibility.
Identifies need for additional information;contacts appropriate source to obtain needed information. Verifies beneficiaryor claimant information if claim is warranted. Identifies payment amount andobtains required management approvals for payment. Processes payment.
Investigates moderate to highly complex claimsand determines level or resolution if appropriate; advises claimant of status;assists in negotiating settlement and resolution of claim.
Receives demand letters; researches andinvestigates claims, responds within individual parameters and escalates asappropriate.
Researches customer inquiries and responds toappropriate parties in a timely manner.
Processes requests and updates administrativesystem with results of inquiry to include proper documentation.
Performs data entry and matches documents toappropriate accounts to ensure up to date and accurate information.
Monitors daily transactions to ensure policy andprocedures are in accordance with service level agreement.
Training Employees will work closely with training staff during the first 6 – 8weeks. Employees will shadow senior staff members and gain hands on experiencewith day to day functions of job, learn internal systems and become acclimatedwith DXC procedures.
- Process Training
Selling points Will gainground up valuable industry knowledge that will allow them to move up intoother opportunities in DXC.
Challenging role in which every day will bedifferent
Defined Career path
Department is experience tremendous growth Qualifications Basic Qualifications
High school diploma or G.E.D.
Zero or more years of customer service or other telephone experience
Experience working with organizational functions and personnel
Experience working with fax machines, computer software, and telephone technology
Experience working with and skilled in the use of help desk software Other Qualifications
Basic business and analytical problem solving skills
Basic communication skills
Ability to follow oral and written directions DXC Technology is an Equal Opportunity/Affirmative Action employer. All qualified candidates will receive consideration for employment without regard to disability, protected veteran status, race, color, religious creed, national origin, citizenship, marital status, sex, sexual orientation/gender identity, age (40 or over), or genetic information. DXC's commitment to diversity and inclusive selection practices includes ensuring qualified long-term unemployed job seekers receive equal consideration for employment. DXC Technology is EEO F/M/Protected Veteran/ Individual with Disabilities
Provider Claims Clerk - Eau Claire, WI
Position Description: Welcome to one of the toughest and most fulfilling ways to help people, including yourself.
We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. Grow your career with an industry leader!
We have training classes starting soon. Apply now! You’re looking for something bigger for your career.
You’re looking for a place where you will be empowered to be your best. When you join UnitedHealthcare, you’ll be part of a team committed to reshaping the way health care works for millions. You’ll join us on a mission to not only deliver the best customer service in the health care industry, but the best customer service.
You won’t just provide customer service; you’ll change health care for the better starting with every health care provider you talk to. Your commitment to supporting them will directly translate into better care for their patients. And you’ll be well supported with the latest tools and advanced training classes to set you up for success.
Don’t wait to join us! There’s never been a better time than now to start doing your life’s best work. When you join our team as a Providers Claims Clerk, you’ll be responsible for supporting the intake of Provider claims reconsideration requests through researching the type of request, claims history, and accurately routing to the correct adjustment department for completion.
The position will be based out of our Eau Claire, WI office. Primary
Ensure all adjustment requests are entering into the system within required timeframes to meet performance guarantees Participate in meetings to share, discuss, and solution for question or error trends, as well as potential process improvements Identify issue trends affecting multiple areas and escalate to appropriate partners Participate in individual coaching sessions as requested by management Attend group training sessions as requested by management Provide expertise or general claims support by reviewing, researching, investigating, and entering all types of reconsideration requests Analyze and identify trends and report as necessary Consistently meet established productivity, schedule adherence, and quality standards Works independently May act as a resource for others or back up for SME May be a resource for new hires May work complex special projects
High School Diploma / GED Able to type minimum 40 WPM and 10-Key of 10K or better Previous data entry experience Experience using a computer and Windows PC applications, which includes strong keyboard and navigation skills and learning new computer programs Experience using Microsoft Word (create, update, and format documents) and Microsoft Excel (create, update spreadsheets, pivot tables, and sort data) Monday
Friday 8-hour shift between 6:00am
6:00pm with weekends and overtime based on business needs Careers at UnitedHealthcare Community & State. Challenge brings out the best in us.
It also attracts the best. That's why you'll find some of the most amazingly talented people in healthcare here. We serve the healthcare needs of low income adults and children with debilitating illnesses such as Cardiovascular Disease, Diabetes, HIV/AIDS and High-risk Pregnancy.
Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive Healthcare, Community, and Government partners to heal healthcare and create positive change for those who need it most.
This is the place to do your life’s best work. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Keywords: claims, medical claims, healthcare claims, claims processing, claims processor; office, UnitedHealth Group, UnitedHealthcare, training class, customer service representative, customer service, CSR, Data Entry, adjustments, phone support 9e39a06c-9271-4842-a6e4-80141161e400 *Provider Claims Clerk
Eau Claire, WI* Wisconsin-Eau Claire738152
Claims Representative II Or II | Cerritos, CA | 136262
Description Your Talent. Our Vision.
At CareMore, a proud member of the Anthem, Inc. family of companies specializing in providing senior Americans a complete and pro-active health care experience, it's a powerful combination. It's the foundation upon which we're creating greater access to care for our members, greater value for our customers and greater health for our communities. Join us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve. Claims Representative Level II: Keys, processes and/or adjusts health claims in accordance with claims policies and procedures.
Works without significant guidance w/ basic understanding of multiple products (HMO, PPO, COB, etc.). Must be able to successfully perform all the duties of the Claims Rep I. Primary duties may include, but are not limited to: Able to handle more complex claims.
Good understanding of the application of benefit contracts, pricing, processing, policies, procedures, gov't regs, coordination of benefits, & healthcare terminology. Good working knowledge of claims and products, including the grievance and/or re-consideration process. Excellent knowledge of the various operations of the organization, products, and services.
Reviews, analyzes and processes claims/policies related to events to determine extent of company's liability and entitlement. Researches and analyzes claims issues. Responds to inquiries, may involve customer/client contact.
Level III Keys, processes and/or adjusts health claims in accordance with claims policies and procedures. Must be able to successfully perform all the duties of the Claims Rep II Primary duties may include, but are not limited to: Fully proficient in all key areas; performs many complex functions.
May participate in claims workflow projects. Responds to telephone and written inquiries and initiates steps to assist callers regarding issues relating to the content or interpretation of benefits, policies and procedures, provider contracts, and adjudication of claims. Adjusts voids and reopens claims on-line within guidelines to ensure proper adjudication May have customer/client contact.
May assist with training of staff. Works without significant guidance. Qualifications Level II:
HS diploma or GED 1 to 3 years of claims processing experience; previous experience using PC, database system, and related software (word processing, spreadsheets, etc.) or any combination of education and experience, which would provide an equivalent background. Level III:
HS diploma 3 to 5 years of Anthem claims experience; or any combination of education and experience, which would provide an equivalent background. SDL2017
Claims Representative II Or II | Cerritos, CA | 136262
/Your Talent. Our Vision./* At CareMore*, a proud member of the Anthem, Inc. family of companies specializing in providing senior Americans a complete and pro-active health care experience,it’s a powerful combination. It’s the foundation upon which we’re creating greater access to care for our members, greater value for our customers and greater health for our communities. Join us and together we willdrive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve. *Claims Representative* Level II: Keys, processes and/or adjusts health claims in accordance with claims policies and procedures. Works without significant guidance w/ basic understanding of multiple products (HMO, PPO, COB, etc.). Must be able to successfully perform all the duties of the Claims Rep I. Primary duties may include, but are not limited to:
Able to handle more complex claims.
Good understanding of the application of benefit contracts, pricing, processing, policies, procedures, gov't regs, coordination of benefits, & healthcare terminology.
Good working knowledge of claims and products, including the grievance and/or re-consideration process.
Excellent knowledge of the various operations of the organization, products, and services.
Reviews, analyzes and processes claims/policies related to events to determine extent of company's liability and entitlement.
Researches and analyzes claims issues.
Responds to inquiries, may involve customer/client contact.
Level III Keys, processes and/or adjusts health claims in accordance with claims policies and procedures. Must be able to successfully perform all the duties of the Claims Rep II Primary duties may include, but are not limited to:
Fully proficient in all key areas; performs many complex functions.
May participate in claims workflow projects.
Responds to telephone and written inquiries and initiates steps to assist callers regarding issues relating to the content or interpretation of benefits, policies and procedures, provider contracts, and adjudication of claims.
Adjusts voids and reopens claims on-line within guidelines to ensure proper adjudication
May have customer/client contact.
May assist with training of staff.
Works without significant guidance. Level II: * HS diploma or GED * 1 to 3 years of claims processing experience; previous experience using PC, database system, and related software (word processing, spreadsheets, etc.) or any combination of education and experience, which would provide an equivalent background. Level III: * HS diploma * 3 to 5 years of Anthem claims experience; or any combination of education and experience, which would provide an equivalent background.
- Equal Employment Opportunity Statement Anthem, Inc. will recruit, hire, train and promote persons in all job titles without regard to age, color, disability, gender (including gender identity), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or other status protected by applicable law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.
Title:Claims Representative II or II | Cerritos, CA | 136262
Kforce has a client that is seeking a Claims Clerk in Irving, Texas (TX).
Responsible for timely and accurate sorting, screening and batching of all Medicaid claim forms, as well as coding of third party payer; and Medicare crossover if required by state contract
Accountable for preparing and mailing provider remittance advice and Return to Provider letters in an efficient manner
Opens and sorts all incoming mail
Screens medical claim forms for pertinent information
Batches medical claim forms by claim type
Completes Code Sheets for Third Party Liability and / or Medicare Crossover claims
Prepares, for mailing, Return to Provider (RTP) letters for returning claims with missing information required to enter into the claims payment system
Prepares Remittance Advices weekly for mailing to providers
Meets established production and quality standards
Supports all departmental initiatives in improving overall efficiency
High School diploma or GED / equivalent required * 2-4 years of relevant experience
Ability to lift to 50 pounds
Basic knowledge of Microsoft Office Outlook
Ability to maintain attendance to support required quality and quantity of work
Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA) * Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.
Minimum Compensation:13.50Maximum Compensation:*14.15
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