Claims Processor
Claims Processor
Posted on :
13-02-2025
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1 Vacancy
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Job Description
Job Title: Claims Processor
Location: Mason OH 45040
Duration: 10 Months
Onsite 5 days a week for first few months will be workplace only with possible hybrid opportunity with 3 days office and 2 days remote possible not guaranteed
Hours: MF/FullTime; 84:30 (30Minute lunch)
GENERAL FUNCTION:
- Accurately and efficiently processes manual claims and other simple processes such as claims projects. Through demonstrated experience and knowledge process standard noncomplex claims requiring a basic knowledge of claims adjudication.
MAJOR DUTIES & RESPONSIBILITIES:
- Processing Efficiently and accurately processes standard claims or adjustments
- Consistently achieves key internals with respect to production cycle time and quality
- May participate on noncomplex special claims projects initiatives including network efforts
- Understands and quickly operationalizes processing changes resulting from new plans benefit designs.
- Drive client satisfaction Works with supervisor and coworkers to provide strong customer service and communication with key customer interfaces that include Account Managers Operations Information Systems Client Representatives and leadership team
- Drives Key Performance Indications Consistently meets or exceeds agreed upon performance standards in both productivity and accuracy
- Proactively works with supervisor to develop selfremediation plan when standards are not being met
KNOWLEDGE & SKILLS:
- Data entry and claims processing knowledge
- Has a working knowledge of interface systems that include the claims system Metastorm Exclaim and EyeNet
- Some basic working knowledge of software programs specifically Excel and Access
- Understands third party benefits and administration
- Strong customer service focus
- Ability to work well under pressure and multitask
EXPERIENCE:
- a years of claims processing/data entry experience. Knowledge of PCs and spreadsheet applications
EDUCATION: High school mandatory
There will actually be 5 courses that required
Employment Type
Full Time
Key Skills
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