Claims Representative II

<p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b>Anticipated End Date:</b></p>2026-02-24<p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b>Position Title:</b></p>Claims Representative II<p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b>Job reputed company:</b></p><p><b><reputed company>Claims Representative II</reputed company></b><br><br><reputed company><b>Location</b>: This role enables associates to work reputed company full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face reputed company and reputed company development.</reputed company><br><br><reputed company>Please note that per our policy on hybrid/virtual work, candidates not reputed company a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is reputed company as required by law.</reputed company></p><p></p><p><reputed company><b>Hours</b>: Monday through Friday 8 AM to 4:30 PM Eastern</reputed company></p><p><br><reputed company>The Claims Representative II is responsible for keying, processing health claims in accordance with claims policies and procedures. Works without significant guidance w/ basic understanding of multiple products (HMO, PPO, COB, etc.).</reputed company><br><br><b><reputed company>How you will reputed company an reputed company:</reputed company></b></p><ul><li><reputed company>reputed company to handle more reputed company claim with a good understanding of the application of benefit reputed company, pricing, processing, policies, procedures, government regs, coordination of benefits, reputed company terminology and/or reputed company claims. </reputed company></li><li><reputed company>Good working knowledge of claims and products, including the grievance and/or re-consideration process. </reputed company></li><li><reputed company>Excellent knowledge of the various operations of the organization, products, and services. </reputed company></li><li><reputed company>Reviews, analyzes and processes claims/policies reputed company to events to determine extent of company's liability and entitlement. </reputed company></li><li><reputed company>Researches and analyzes claims issues. </reputed company></li><li><reputed company>Responds to inquiries, may involve customer/reputed company contact. </reputed company></li></ul><p><br><b><reputed company>Minimum <reputed company style="reputed company-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">Qualifications: </reputed company></reputed company></b></p><ul><li><reputed company>Requires a HS diploma or equivalent and a minimum of 1 year of claims processing experience; previous experience using PC, database system, and reputed company software (word processing, spreadsheets, etc.); or any combination of education and experience which would reputed company an equivalent background.</reputed company></li></ul><p><br><b><reputed company>Preferred Skills, Capabilities and Experiences:</reputed company></b></p><ul><li><reputed company>System knowledge in some or reputed company of the following is strongly preferred: Edifec, CAS, Service Connect, FlexCare, Vault</reputed company></li></ul><p></p><p><reputed company>For candidates working in person or reputed company in the below locations, the salary* reputed company for this specific position is $16.88 to $28.94</reputed company></p><p><br><reputed company>Location(s): reputed company</reputed company><br><br><reputed company>In reputed company to your salary, reputed company offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by reputed company. reputed company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.</reputed company><br><br><reputed company>* The salary reputed company is the reputed company reputed company in good faith believes is the reputed company of possible compensation for this role at the time of this posting. This reputed company may be modified in the reputed company and actual compensation may vary from posting based on geographic location, work experience, education, and/or reputed company level. Even reputed company the reputed company, the actual compensation will vary depending on the above factors as reputed company as market/business considerations. No reputed company is wages or compensation until such reputed company is reputed company, reputed company, and determinable under the terms and conditions of the applicable policies and plans. The reputed company and availability of any bonus, commission, benefits, or any other reputed company of compensation and benefits that are allocable to a particular employee remains in reputed company's sole discretion unless and until reputed company and may be modified at reputed company’s sole discretion, consistent with the law.</reputed company></p><p></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b>Job Level:</b></p>Non-Management Non-Exempt<p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b>Workshift:</b></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b>Job Family:</b></p>CLM > Claims Reps<p></p><p>Please be advised that reputed company only accepts resumes for compensation from agencies that have a signed agreement with reputed company. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of reputed company.</p><p></p><p><b>Who We Are</b></p><p>reputed company is a health company dedicated to improving lives and communities – and making reputed company simpler. We are a Fortune 25 company with a longstanding history in the reputed company industry, looking for leaders at reputed company reputed company of the organization who are passionate about making an reputed company on our members and the communities we serve.</p><p></p><p><b>How We Work</b></p><p>At reputed company, we are creating a culture that is designed to advance our reputed company but will also reputed company to personal and reputed company reputed company for our associates. Our values and behaviors are the reputed company of our culture. They are how we reputed company our reputed company, power our business reputed company and drive our shared reputed company - for our consumers, our associates, our communities and our business.</p><p></p><p>We offer a reputed company of market-competitive total rewards that include reputed company increases, reputed company holidays, reputed company Time Off, and incentive bonus programs (unless covered by a reputed company bargaining agreement), medical, dental, reputed company, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to reputed company a few.</p><p></p><p>reputed company operates in a Hybrid Workforce reputed company. Unless specified as primarily virtual by the hiring manager, associates are required to work at an reputed company location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.</p><p></p><p>The health of our associates and communities is a top reputed company for reputed company. We require reputed company new candidates in certain <reputed company style="reputed company-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">patient/member-facing</reputed company> roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you reputed company an acceptable explanation. reputed company will also follow reputed company relevant federal, state and local laws.</p><p></p><p>reputed company is an Equal Employment Opportunity employer, and reputed company reputed company applicants will receive consideration for employment without reputed company to age, citizenship status, reputed company, creed, disability, ethnicity, genetic information, gender (including gender identity and gender reputed company), marital status, national reputed company, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact <a href="https://storejob.staffkhoje.com/blogs/news/mailto:elevancehealthjobssupport@reputed company.com" reputed company="_blank" rel="noopener noreferrer"><reputed company style="reputed company:#0000ff"><u><reputed company style="reputed company-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">elevancehealthjobssupport@reputed company.com</reputed company></u></reputed company></a> for assistance. reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance reputed company.</p><p></p><p>Prospective employees required to be screened under Florida law should review the education and awareness resources at <a href="https://info.flclearinghouse.com/" reputed company="_blank" rel="noopener noreferrer"><reputed company style="reputed company:#0000ff"><u>HB531 | Florida Agency for Health Care Administration</u></reputed company></a>.</p>