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Job Requirements of Claims Processor:
-
Employment Type:
Contractor
-
Location:
Mason, OH (Onsite)
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Claims Processor
Careers Integrated Resources Inc
Mason, OH (Onsite)
Contractor
Title - Claims Processor
Location: Mason OH - Hybrid - 3x a wee(Tuesday, Wednesday and Thurs)k; Training 100% on site.
Duration: 2 month(s) and Possibility of Extension
REASON FOR REQUEST:
Approved centralization of Routine Billing for Team Vision; 7 individual contributor roles approved; will use a temp to perm model to hire centralized team in Mason, OH
GENERAL FUNCTION: 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.
MAJOR DUTIES & 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
KNOWLEDGE & SKILLS:
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
EXPERIENCE:
0-1 years of claims processing/data entry experience. Knowledge of PCs and spreadsheet applications
EDUCATION:
High school mandatory
Location: Mason OH - Hybrid - 3x a wee(Tuesday, Wednesday and Thurs)k; Training 100% on site.
Duration: 2 month(s) and Possibility of Extension
REASON FOR REQUEST:
Approved centralization of Routine Billing for Team Vision; 7 individual contributor roles approved; will use a temp to perm model to hire centralized team in Mason, OH
GENERAL FUNCTION: 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.
MAJOR DUTIES & 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
KNOWLEDGE & SKILLS:
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
EXPERIENCE:
0-1 years of claims processing/data entry experience. Knowledge of PCs and spreadsheet applications
EDUCATION:
High school mandatory
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