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Claims Adjuster I

Iconma

Remote, MD(remote)

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JOB DETAILS
SALARY
$22.75–$25.75 Per Hour
SKILLS
Analysis Skills, Claims Processing, Communication Skills, Customer Support/Service, Data Analysis, Detail Oriented, Disbursements, Documentation, Health Insurance, Health Plan, Healthcare, Healthcare Providers, High School Diploma, Information/Data Security (InfoSec), Insurance Claims, Medical Terminology, Operations Processes, Presentation/Verbal Skills, Subrogation, Time Management, Trend Analysis, Worker's Compensation, Writing Skills
LOCATION
Remote, MD(remote)
POSTED
25 days ago
Our client, a Health Insurance company, is looking for a Claims Adjuster I for their Remote location.
 
Responsibilities:
  • Investigate and perform adjustment of claims and ensure that claims are handled properly within authority limits, and in line with standard procedures and guidelines.
  • Verifies insurance claims by reviewing claims requirements; examining documentation and calculations; highlighting and summarizing out-of-line situations; recommending changes in operating processes; completing reports, logs, and audit records.
  • 60% Proactively investigate and perform adjustments of claims.
  • Ensure claims are handled within authority limits, and in line with standard procedures and guidelines.
  • 20% Updates claims audit records by entering, verifying, and securing data.
  • 10% Settle standard/complex claims through payment or denial.
  • 5% Provides claims audit information and reports by collecting, analyzing, and summarizing data and trends.
  • 5% Improves claims adjustment job knowledge by attending training sessions
 
Requirements:
  • High School Diploma or GED
  • 3 years years claims experience and complete understanding of all systems, policies and procedures.
  • Knowledge, Skills and Abilities (KSAs)
  • Ability to analyze information gathered from investigation, Proficient
  • Excellent communication skills both written and verbal., Proficient
  • Ability to recognize, analyze, and solve a variety of problems., Proficient
  • Skill in completing assignments accurately with attention to detail., Proficient
  • The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes them ineligible to perform work directly or indirectly on Federal health care programs.
  • Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time.
  • Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.
  • Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
  • Medical Claims processing experience.
  • Medical Claims Adjustment experience.
  • Medical Terminology, Provider Refund.
  • Subrogation, Workers Comp.
  • Disbursements.
 
Why Should You Apply?  

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About the Company

I

Iconma

ICONMA is a global information consulting management firm providing Professional Staffing Services and Project-Based Solutions for organizations in a broad range of industries.

  • Corporate Headquarters in Troy, Michigan; 20+ locations worldwide.
  • Certified Woman-Owned Business Enterprise (WBE); certified by Women’s Business Enterprise National Council, National Women Business Owners Corporation (NWBOC); and California Public Utilities Commission (CPUC).
  • Founded in 2000
  • 2000+ Employees

The company was founded on the principle that success is derived from delivering high quality service and resources in the most responsive, flexible, and innovative way. ICONMA invests in people and resources with a single goal: To provide our customers with the highest quality service in the most responsive manner. Through its network of offices, ICONMA provides the resources to help clients maintain their competitive advantage.

COMPANY SIZE
2,000 to 2,499 employees
INDUSTRY
Management Consulting Services
EMPLOYEE BENEFITS
401K, Employee Referral Program, Life Insurance
FOUNDED
2000
WEBSITE
https://www.iconma.com/

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