Claims Processor

Job Title: Claims Processor
Job Location: Mason OH ( Hybrid 3 days office and 2 days remote )
Job Duration: 1-2 Months (possibility of extension)
Shift: 8:00am - 5:00pm with hour lunch, or 8:00am - 4:30pm with 30 minute lunch
Payrate: $18.00/ hr. on w2

Onsite 5 days a week for first few months will be workplace only with possible hybrid opportunity with 3 days office and 2 days remote - possible not guaranteed

Job Summary:

• 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.

Duties and 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.

Education:

• High school mandatory.

Experience:

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

Knowledge, Skills and Abilities:

• Data entry and claims processing knowledge.
• Has a working knowledge of interface systems that include the Client claims system, Metastorm, Exclaim and EyeNet.
• 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.