Remote Medical Claims Representative

TEKsystems

1d•Remote

About The Position

The REMOTE CSR provides customers with timely, accurate, and customer-focused benefit and claim information for all of the products administered by Client. These products include SB Medical, Accident, Critical Illness, Rx, Dental, Vision, and MEC products. The CSR will solicit and enter the information needed to enter and process claims accurately and in a timely manner.

Requirements

Knows CPT/HCPCS/REV/ICD 10 codes and the forms that providers and facilities use to bill insurance companies
1-2+ Years of previous experience within health insurance claims and benefits particularly - Scheduled Accident, Critical Illness, or Hospital Indemnity.
1+ year call center experience
Know how to read medical claims forms (HCFA 1500 & UB04)
Understand how to read medical records, EOBs, CPT codes
CPT and ICD 10 code knowledge.
Must have medical claims experience - dr visits, diagnostic testing, hospital stays, etc.
Know what a HCFA 1500 is.
Know what a UB04 is
If candidates are in CST or EST, they must have experience working a later shift (Monday - Friday | 11:30am - 8:00pm EST)

Nice To Haves

Mountain and Pacific Time Zones preferred.
remote call center preferred

Responsibilities

Average 40-50 Customer Service Calls per day: Provide customers with timely, accurate, and customer-focused benefit and claim information.
Solicit and enter the information needed to enter and process claims accurately and in a timely manner.
Record summaries of information exchanged in our claim system with a high level of accuracy and detail easily understood by the user.
Issue timely and accurate claim acknowledgement correspondence.
Process incoming documents with high coding integrity and distribute immediately.
Claims Registration: Enter incoming claims information with high degree of accuracy, meeting or exceeding established metrics.
ENTER 20 Claims per day.
Perform other tasks requested by management.