Claims Processor/Data Entry

Job Summary:

• Temporary Resource to Support a Medically Necessary Contacts Processing.
• Accurately and efficiently processes manual claims and other simple processes such as claims projects. Through demonstrated experience and knowledge, process standard, non-complex claims requiring a basic knowledge of claims adjudication.

Responsibilities:

• Processing - Efficiently and accurately processes standard claims or adjustments.
• Consistently achieves key internals with respect to production, cycle time, and quality.
• May participate on non-complex special claims projects initiatives, including network efforts.
• Understands and quickly operationalizes processing changes resulting from new plans, benefit designs.
• Drive client satisfaction - Works with supervisor and co-workers to provide strong customer service and communication with key customer interfaces that include Client Account Managers, Operations, Information Systems, Client Representatives and Client leadership team.
• Drives Key Performance Indications - Consistently meets or exceeds agreed upon performance standards in both productivity and accuracy.
• Proactively works with supervisor to develop self-remediation plan when standards are not being met.

Experience:

• 0-1 years of claims processing/data entry experience.
• Knowledge of PCs and spreadsheet applications.

Education:

• High school mandatory.

Skills:

• Data entry and claims processing knowledge.
• Has a working knowledge of interface systems that include the Client claims system, Meta storm, Exclaim and Eye Net.
• Some basic working knowledge of software programs, specifically Excel and Access.
• Understands third party benefits and administration.
• Strong customer service focus.
• Ability to work well under pressure and multi-task.