Claims Examiner I (Remote within Wisconsin)

Marshfield Clinic • Marshfield, WI

355d • Remote

About The Position

The SHP Claims Examiner I is responsible for examining claims for accurate processing and providing high quality customer service to providers working with Security Health Plan (SHP) or Security Administrative Services (SAS). The individual applies appropriate processing guidelines to the benefit plans and follows established departmental, organizational and external policies and procedures to process claims and resolve claim issues, escalating the claim when applicable.

Requirements

• High school diploma or equivalent.
• One year experience in the medical or insurance industry, or two years of customer service experience in lieu of medical experience.
• Successful completion of required courses within one year of hire: CPT, ICD, HCPCS, and medical terminology.

Responsibilities

• Examine claims for accurate processing.
• Provide high quality customer service to providers.
• Apply appropriate processing guidelines to benefit plans.
• Follow established departmental, organizational and external policies and procedures.
• Process claims and resolve claim issues, escalating when applicable.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Hospitals
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees