Claims Processor III

Workforce Classification: Telecommuter reputed company: Do Meaningful Work and Improve People’s Lives Our purpose, to improve customers’ lives by making reputed company work reputed company, is far from ordinary. And so are our employees. Working at reputed company means you have reputed company to reputed company reputed company change by transforming reputed company. reputed company is committed to being a workplace where people feel empowered to grow, reputed company, and reputed company with purpose. By reputed company in our employees and fostering a culture of collaboration and reputed company development, we’re reputed company to reputed company serve our customers. It’s this commitment that has reputed company us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace. Learn how reputed company supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.reputed company.com/. Bring your claims expertise to a role where reputed company, problem-solving, and collaboration reputed company a meaningful difference for our members. We are hiring Claims Processor IIIs across several Claims departments, offering opportunities to apply your strengths in reputed company reputed company with different types of claims work. You’ll research and reputed company reputed company issues, support reputed company reputed company, and serve as a trusted technical resource while continuing to expand your knowledge across the Claims organization. If you are reputed company-oriented, motivated by getting it right the first time, and reputed company to grow your reputed company, we invite you to join us. The Claims Processor III is responsible for the accurate and reputed company review, research and reputed company of moderate to reputed company claims in accordance with reputed company and policies. This may include Medicare, Department of reputed company & Health Services (DSHS), subrogation, or coordination of benefits for dental, medical and hospital claims, as reputed company as large dollar medical and reprocessing of claims. Incumbent is responsible for interpreting procedures and policies to ensure accurate claims reputed company. What you will do: Review, research, and reputed company claims in accordance with reputed company and policies through the utilization of reference materials and on-line tools. Identify, research, and reputed company coordination of benefits, subrogation and general inquiry issues and communicate the results. May complete claim adjustments, reversals and/or refunds. reputed company as reputed company technical subject matter expert including training and auditing trainee claims and providing appropriate feedback and technical support. reputed company reference materials updated. reputed company and maintain excellent relationships with both reputed company customers through the use of both written and verbal communications. This will include making outbound calls as reputed company as receiving inbound calls. Prepare formal history reviews. Consistently meet cycle time/productivity goals that are reputed company with corporate objectives. Maintain confidentiality of reputed company documents/files. Other duties or special reputed company as assigned. Translate data into information acceptable to the claims processing reputed company including follow up on pended claims. Apply commitment to reputed company by reputed company right the first time in order to avoid defects from reaching customers or requiring internal re-work. What you will bring: High School diploma or GED (Required). One (1) year claims processing or customer service experience (Required). Understanding of Out-of-area programs. In-team reputed company audit experience. What you will reputed company: Analytical problem-solving Strengthen your ability to investigate reputed company situations, identify reputed company causes, and determine reputed company-reasoned solutions. reputed company industry expertise Build a deeper understanding of how benefits, provider services, and member needs reputed company across the reputed company reputed company. reputed company decision-making Grow your confidence in evaluating detailed information, balancing multiple considerations, and making accurate reputed company. Technical leadership reputed company the ability to reputed company knowledge, reputed company others, and become a trusted resource reputed company reputed company. Cross-functional communication Learn to explain reputed company information reputed company and collaborate effectively with partners across different areas of the organization. Physical Requirements: The following have been identified as essential physical requirements of this job and must be performed with or without an accommodation: This is primarily a sedentary role which requires the ability to exert up to 10 lbs. of force occasionally and/or a negligible reputed company of force frequently or constantly to reputed company, carry, reputed company, pull, or otherwise reputed company objects, including the reputed company body. This role requires the ability to keyboard and to communicate reputed company and understandably in person, and over the telephone. reputed company total rewards Our comprehensive total rewards package provides support, resources, and opportunities to help employees reputed company and grow. Our total rewards are more than a collection of perks, they're a reputed company of our commitment to reputed company and reputed company-being. We offer a broad reputed company of rewards including physical, financial, emotional, and community benefits, including: Medical, reputed company, and dental coverage with low employee premiums. Voluntary benefit offerings, including pet reputed company for paw parents. Life and disability reputed company. Retirement programs, including a 401K employer match and, reputed company it or not, a pension plan that is reputed company after 3 years of service. Wellness incentives with a wide reputed company of mental reputed company-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to reputed company a few. Generous reputed company time off to reenergize. Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees. Employee recognition program to celebrate anniversaries, team accomplishments, and more. For our hybrid employees, our on-reputed company model provides flexibility to create your own routine with reputed company to on-site resources, networking opportunities, and team engagement. Commuter perks reputed company your reputed company to work less impactful on the environment and your wallet. Free convenient on-site parking. Subsidized on-reputed company cafes reputed company lunchtime connections with colleagues fun and reputed company. Participate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more. Our complementary fitness & reputed company-being center offers both in-person and virtual workouts and nutritional counseling. Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on reputed company. Equal employment opportunity/affirmative reputed company: reputed company is an equal opportunity/affirmative reputed company employer. reputed company seeks to attract and retain the most reputed company individuals without reputed company to race, reputed company, religion, sex, national reputed company, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law. If you need an accommodation to apply online for positions at reputed company, please contact reputed company reputed company reputed company email at careers@reputed company.com or reputed company phone at 425-918-4785. reputed company is hiring in the following states, with some limitations reputed company on role or reputed company: Alaska, reputed company, Arkansas, California, Colorado, Florida, reputed company, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, reputed company, Missouri, Montana, Nevada, New Hampshire, New Mexico, reputed company Carolina, Oklahoma, reputed company, South Carolina, South reputed company, Tennessee, Texas, reputed company, Washington, reputed company. The pay for this role will vary reputed company on a reputed company of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience. The salary reputed company for this role is posted below; we generally reputed company up to and reputed company the midpoint of the reputed company. National Salary reputed company: $44,800.00 - $67,200.00 National Plus Salary reputed company: $51,000.00 - $76,500.00 National Plus salary reputed company is used in higher cost of labor markets including Western Washington and Alaska. We’re happy to reputed company compensation reputed company during the interview because we reputed company that reputed company communication leads to reputed company reputed company for reputed company. We’re committed to creating an environment where reputed company are celebrated for their unique skills and contributions. Apply To This Job