Claims Analyst III
Modivcare
•$60,800 - $80,000•Onsite
About The Position
This position is responsible for implementing claims processes to maximize effectiveness and accuracy. This includes auditing the accuracy of claims information entered in the system and monitoring the operation of the claims systems. In addition, develops solutions to claims issues and works with systems design to implement new features.
Requirements
- Bachelor's Degree required.
- Five (5) plus years of experience.
- Or equivalent combination of education and/or experience.
- Strong understanding of claims processing and ability to make informed decisions on claim eligibility.
- Excellent attention to detail and proficient data entry skills for accurate claim processing.
- Intermediate proficiency of Microsoft applications (Word, Excel, and Outlook).
- Analytical mindset with the ability to interpret claim data and follow established guidelines.
- Excellent verbal and written communication skills to interact with superior customer-focused demeanor.
- Problem-solving abilities to address claim issues and resolve discrepancies.
- Ability to work independently and as a member of a team.
- Ability to accurately type 35 words per minute and use of 10-key.
Responsibilities
- Reviews claims for irregularities, accuracy and completeness.
- Requests additional information, where necessary, for completion of claim processing.
- Coordinates and processes documentation, invoice dispute resolution and payment for accounts.
- Performs account analysis and researches payment and account discrepancies.
- Identifies and verifies transactions and expedites a resolution of various claims issues.
- Handles complex issues and problems, and refers only the most complex issues to higher-level staff.
- Possesses comprehensive knowledge of subject matter.
- Provides leadership, coaching, and/or mentoring to more junior team members.
- Participate in other projects or duties as assigned.
Benefits
- Medical, Dental, and Vision insurance
- Employer Paid Basic Life Insurance and AD&D
- Voluntary Life Insurance (Employee/Spouse/Child)
- Health Care and Dependent Care Flexible Spending Accounts
- Pre-Tax and Post --Tax Commuter and Parking Benefits
- 401(k) Retirement Savings Plan with Company Match
- Paid Time Off
- Paid Parental Leave
- Short-Term and Long-Term Disability
- Tuition Reimbursement
- Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)
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What This Job Offers
Job Type
Full-time
Career Level
Senior
