Claims Specialist- Anchorage, AK (Hybrid)
About The Position
As Claims Specialist- Anchorage, AK (Hybrid), you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. HMS is hiring Claims Specialists to support our Alaska account. These positions processes moderately complex claims for our Alaska Medicaid client. They will make decisions on payment of medical claims using the existing policy and rules to ensure accurate and timely completion.
Requirements
- Ability to work both independently and as part of a team.
- Strong communication skills with the ability to communicate clearly and effectively in writing and verbally.
- Ability to access and retrieve information using a PC.
- Intermediate understanding of Microsoft Office products.
- Organizational skills to balance and prioritize work, and analytical and problem-solving skills.
Responsibilities
- Review and research suspended medical claims and adjudicate them per DHS policy.
- Refer claims to Utilization Review and Provider Services units.
- Maintain necessary documentation.
- Participate in meetings as necessary.
- Participate in process improvement sessions.
- Train as a back-up for other areas, such as document control, courier, and customer service desk.
- Other duties as assigned
Benefits
- flexible vacation policy
- 401(k) employer match
- comprehensive health benefits
- educational assistance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
