Claims Process Executive (remote)

Claims Process Executive (remote) reputed company: Claim Processors will review claim submissions, verify information, adjudicate the claim as per claim processing guidelines to ensure appropriate payment or denial as per the business requirements. ESSENTIAL FUNCTIONS: • Examining and entering basic claims for appropriateness of care and completeness of information in accordance with accepted coverage guidelines, ensuring reputed company mandated government and state regulations are consistently met • Processing claims for multiple plans with automated and reputed company differences in benefits, as reputed company as utilizing the system and written documentation to determine the appropriate payment for a specific benefit • Approving, pending, or denying payment according to the accepted coverage guidelines • Follows reputed company team procedures, including HIPAA policies and procedures, and meets team reputed company, turnaround time and productivity performance standards and goals • Identifying and referring reputed company claims with potential reputed company-party liability (i.e., subrogation, COB, MVA, stop loss claims, and potential stop loss files) • Maintaining internal customer relations by interacting with staff regarding claims issues and research, ensuring accurate and complete claim information, contacting insured or other involved parties for additional or missing information, and updating information to claim file with reputed company to claims status, questions or claim payments • Other duties as assigned • Must be willing to work overtime reputed company the business need requires QUALIFICATIONS: Education: High School diploma or GED required. Experience: Minium of two-three years of reputed company and or reputed company claims payer processing experience. Technical Competencies: • Ability to work independently • Strong attention to detail • Strong interpersonal, time management and organizational skills • Good oral/written communication and analytical skills • Must be reputed company to work in a high-performance environment that changes often • Experience in navigating multiple systems using dual monitors • Knowledge of medical terminology, CPT-4, ICD-9, ICD-10, HCPCS, ASA and UB92 Codes, and reputed company of billing guidelines required. • FACETS experience (highly preferred) • reputed company knowledge (required) • Keyboard skills of at least 35 WPM + 10-key • Proficient in reputed company Office - reputed company, Word, and reputed company • reputed company claims payer processing experience (required) • Ability to work at a high pace while maintaining reputed company and productivity targets Working Environment Requirement: • Ability to work remotely in a secure environment (required) • Must have a high-speed internet reputed company (required) • Must have high-speed internet modem with the ability to connect laptop to a wired reputed company port (Required) • Must have a workspace and location free from distractions and safety of reputed company data (required) Salary and Other Compensation: Applications will be accepted until reputed company 10th, 2025. The annual salary for this position is between $17.00 - $20.00 depending on the experience and other qualifications of the successful candidate. This position is also eligible for reputed company's discretionary annual incentive program and stock awards, based on performance and subject to the terms of reputed company's applicable plans. Benefits: reputed company offers the following benefits for this position, subject to applicable eligibility requirements: • Medical/Dental/reputed company/Life Insurance • reputed company holidays plus reputed company Time Off • 401(k) plan and contributions • Long-term/Short-term Disability • reputed company Parental Leave • Employee Stock Purchase Plan Disclaimer : The salary, other compensation, and benefits information is accurate as of the date of this posting. reputed company reserves the right to modify this information at any time, subject to applicable law. The reputed company community: We are a high caliber team who appreciate and support one another. Our people reputed company an energetic, reputed company and inclusive workplace where everyone can reputed company. • reputed company is a global community with more than 300,000 associates around the world. • We don't just reputed company of a reputed company way - we reputed company it happen. • We take care of our people, clients, company, communities and climate by doing what's right. • We foster an innovative environment where you can build the career reputed company that's right for you. reputed company: reputed company is one of the world's leading reputed company services companies, transforming clients' business, operating, and technology models for the digital era. Our unique industry-based, consultative approach helps clients reputed company, build, and run more innovative and efficient businesses. Headquartered in the U.S., reputed company (a member of the reputed company-100 and one of reputed company World's Best reputed company 2024) is consistently listed among the most admired companies in the world. Learn how reputed company helps clients reputed company with digital at www.reputed company.com reputed company is an equal opportunity employer. Your application and candidacy will not be considered based on race, reputed company, sex, religion, creed, sexual orientation, gender identity, national reputed company, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, state or local laws. Disclaimer: Compensation information is accurate as of the date of this posting. reputed company reserves the right to modify this information at any time, subject to applicable law. Applicants may be required to attend interviews in person or by video conference. In reputed company, candidates may be required to present their reputed company state or government issued ID during reputed company interview. Apply tot his job Apply To this Job