Claims Specialist I

Modivcare•Norton, VA

9d•$15

About The Position

Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you! Modivcare is looking for a Claims Specialist I to join our team. This position is responsible for processing and managing claims submitted by providers, including verifying the accuracy and completeness of documentation and attachments. This role…

Requirements

High School Diploma required.
Zero (0) plus years of experience. Or equivalent combination of education and/or experience.
Strong attention to detail and data entry skills to ensure claim accuracy.
Basic computer proficiency, including Microsoft Word, Excel, and Outlook.
Analytical mindset with the ability to interpret claim data and follow established procedures.
Effective verbal and written communication skills with a superior customer-focused demeanor.
Problem-solving skills to address claim discrepancies and issues.
Ability to work both independently and as part of a collaborative team.

Responsibilities

Reviews incoming claims and related documentation to ensure accuracy and completeness.
Inputs claim data and pertinent information into the claims processing system.
Reviews company policies to determine coverage and assess the validity of claims.
Uses standard scripts or form letters to request missing information.
Applies established guidelines and policies to determine claim eligibility and process accordingly.
Communicates with providers when necessary to obtain additional information or clarify claim details.
Adheres to departmental policies, deadlines, and procedures for claim handling.
Reports suspected fraudulent claims to the Fraud, Waste, and Abuse (FWA) department.
May participate in special projects or perform other 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!)