UNKNOWN

ADAPTED_NOW

HOUR

Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Determines whether to return, deny or pay claims following organizational policies and procedures.

Advance your career with Mindlance! We have been connecting talented IT professionals with world-class companies since 1999. Mindlance is here to help you to find the perfect fit with just the right company. Currently, we are seeking an Operational Analyst for an exciting career growth opportunity. Make your next big career move with the kind of position that will allow you to be genuinely passionate about the work you do! Our recruiters will work closely with you to help you get the edge over the competition. Let Mindlance advocate for you – apply today! “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”  Job Title: Claims Processer Max pay: $20.00Min Pay: $16.00Job Category: Admin/ClericalIndustry: InsuranceJob Location: Surfside Beach, SCZip Code: 29575Top 3/5 Skills:·      Claims Processing·      Medical Claims ·      Data Entry Job ResponsibilitiesReviews and adjudicates complex or specialty claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Assists in training or mentoring new staff members. Examines and processes complex or specialty claims according to business/contract regulations, internal standards and examining guidelines. Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Verifies that claims have been keyed correctly. Job RequirementsClaims ProcessingData EntryHealthcare Insurance industry experience

Mindlance

Claims Processer

Adjudication

Claims Processing

Data Entry

Health Insurance

Insurance

Operational Audit

Process Analysis

Regulations

cb_wl_jobs_master

PERMANENT

FULL_TIME

Experience: 1 year of experience in a claims/appeals processing, customer service, or other related support area OR Bachelor's Degree in lieu of work experience. US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.

Duration: 3+ Months Possible Contract (Possible Conversion) Job Description:<ul><li>Responsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures.</li><li>Responds to written and/or telephone inquiries according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity, and quality are met. Accurately documents inquiries. Identifies incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines.</li></ul>  Responsibilities:<ul><li>Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines. Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Ensures claims are processing according to established quality and production standards.</li><li>Identifies complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution. Identifies and promptly reports and/or refers suspected fraudulent activities and system errors to the appropriate departments.</li><li>Required Skills and Abilities: Good verbal and written communication skills. Strong customer service skills. Good spelling, punctuation and grammar skills. Basic business math proficiency. Ability to handle confidential or sensitive information with discretion.</li><li>Required Software and Tools: Microsoft Office</li></ul>  Education:<ul><li>Required Education Level and Degree Type: High School Diploma or equivalent</li><li>Required Work Experience: Experience processing, researching and adjudicating claims</li><li>Experience: 1 year of experience in a claims/appeals processing, customer service, or other related support area OR Bachelor's Degree in lieu of work experience.</li></ul>  About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit <a href="http://www.ustechsolutionsinc.com" rel="nofollow" title="www.ustechsolutionsinc.com">www.ustechsolutions.com</a>.   US Tech Solutions is an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

US Tech Solutions, Inc.

Healthcare Customer Service Representative

Communication Skills

Customer Support/Service

Healthcare Customer Service

Mathematics

Microsoft Office

Presentation/Verbal Skills

Writing Skills

monster

FEED

45% Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries. •10% Identifies complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution.

Call center is open from 8am - 7pm. Shift may change once training is up. Contract role potential for conversion to FTE Pay Rate: $23.11/HR Responsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures. •45% Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries. Handles situations which may require adaptation of response or extensive research. Identifies incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines. •45% Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines. Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Ensures claims are processing according to established quality and production standards. •10% Identifies complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution. Identifies and reports potential fraud and abuse situations. null Required Skills and Abilities: Good verbal and written communication skills. Strong customer service skills. Good spelling, punctuation and grammar skills. Basic business math proficiency. Ability to handle confidential or sensitive information with discretion. Required Software and Other Tools: Microsoft Office. Work Environment: Typical office environment. null

We are a $125 Million, NMSDC-certified Minority & Woman owned Workforce Solutions Company headquartered in the DC metro area with presence across US with global presence - Canada, Mexico, India, UK, Malaysia, Indonasia, Hongkong, Singapore, UAE. We are specialized in providing Workforce Solutions, SOW project delivery, Engineering Solutions, Creative Services. We currently support 100+ Fortune companies globally and across multiple industry segments. We are currently supporting several massive programs across industry segment nationally/globally (Intel, Ally, AMD, QUALCOMM, Morgan Stanley, Kraft/ Mondelez, MNP, Amdocs, Dell, SanDisk, Medtronic, Becton Dickinson, GE, Lockheed Martin, UTC, L-3 Communications, Caterpillar, BMW, Mercedes Benz, National Grid, Dominion, Energy Future Holdings, PSEG, 3M, Fidelity, Aetna, Humana, Johnson & Johnson, Pfizer, Merck etc). 
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, identity, national origin, disability, or protected veteran status.

LanceSoft Inc

Claims Customer Service Advocate II

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Claims ProcesserMindlance

Healthcare Customer Service RepresentativeUS Tech Solutions, Inc.

Claims Customer Service Advocate IILanceSoft Inc

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