Claims Representative I (Health & Dental)

Elevance Health

102d

About The Position

Claims Representative I Location Hybrid 1: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Office Location: 654 Avenue Luis Munoz Rivera, San Juan, 00918 The Claims Representative I responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery.

Requirements

• HS diploma or equivalent and related experience; or any combination of education and experience which would provide an equivalent background.

Nice To Haves

• Good oral and written communication skills.
• Previous experience using PC, database system, and related software (word processing, spreadsheets, etc.) strongly preferred.
• Familiarity with Medicare/Medicaid and claims.
• Medical background (e.g., hospital or dental office experience).
• Data entry experience.
• Experience working with production goals.
• Call center experience.

Responsibilities

• Learning the activities/tasks associated with his/her role.
• Works under direct supervision.
• Relies on others for instruction, guidance, and direction.
• Work is reviewed for technical accuracy and soundness.
• Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made.
• Researches and analyzes claims issues.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs
• Medical benefits
• Dental benefits
• Vision benefits
• Short and long term disability benefits
• 401(k) + match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources

What This Job Offers

• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees