Health Plans Claims Processor

University of Utah Health • Murray, UT

3d • Onsite

About The Position

This position for use in University of Utah Health Plans only. The Claims Processor position is responsible for following manual processes to finalize claims while optimizing efficiency, service and quality. This position is not responsible for providing care to patients.

University of Utah Health is an integrated academic healthcare system with five hospitals including a level 1 trauma center, eleven community health centers, over 1,600 providers, and a health plan serving over 200,000 members. University of Utah Health is nationally ranked and recognized for our academic research, quality standards and overall patient experience. In addition to our clinical delivery system, we have a School of Medicine, School of Dentistry, College of Nursing, College of Pharmacy, and College of Health providing education and training for over 1,250 providers annually. We have over 2 million patient visits annually and research grants exceeding $350 million. University of Utah Hospitals and Clinics represents our clinical operations for the larger health system.

Requirements

• Ability to perform the essential functions of the job as outlined above.
• Experience with claims processing in a health care delivery setting or with insurance payers.
• Ability to work effectively, independently, and as part of a team.
• Strong organization, time management and project management skills and multi-tasking abilities.
• Detail oriented with problem-solving abilities.
• Demonstrates strong communication skills.
• One year of experience as a medical claims processor, or equivalent.

Responsibilities

• Supports and promotes University of Utah Health Plan's mission, vision, values, and goals.
• Contributes to positive and productive team environment.
• Maintains accountability for claim performance expectations.
• Enters claims data into system while interpreting coding and understanding medical terminology in relation to diagnoses and procedures.
• Processes claim forms, adjudicates for allocation of deductibles, co-pays, co-insurance maximums and provider reimbursements.
• Follows adjudication policies and procedures to ensure proper payment of claims.
• Assists in testing system functionality during system upgrades and implementations.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed