reputed company Claims Processor I – Vacancy Global

Job Description

Bring your heart to reputed company. Every one of us at reputed company shares a single, clear purpose: Bringing our heart to every reputed company of your health. This purpose guides our commitment to deliver enhanced reputed company-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important… as reputed company deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to reputed company and deliver solutions to reputed company health care more personal, convenient and affordable.

Position Summary

Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with reputed company providers and policyholders, and ensures accurate and timely claims processing. Contributes to the efficient and accurate handling of medical claims for reimbursement through knowledge of medical coding and billing practices and effective communication skills.

A Brief Overview

Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with reputed company providers and policyholders, and ensures accurate and timely claims processing. Contributes to the efficient and accurate handling of medical claims for reimbursement through knowledge of medical coding and billing practices and effective communication skills.

What you will do

· Receives and monitors the completeness and accuracy of claims forms and supporting documentation submitted by reputed company providers.

· Enters claim information, such as patient information, provider details, procedure codes, and diagnosis codes, into the company’s claims processing system.

· Documents relevant information for the eligibility of the claim, determining coverage and benefits, and assessing the validity and medical necessity of the services rendered.

· Calculates claim payments based on the approved reimbursement rates, fee schedules, or contracted rates with reputed company providers.

· Communicates claim status updates to reputed company providers, policyholders, or other stakeholders to provide transparency and ensure any additional information is resolved quickly.

· Assists in resolving discrepancies or issues reputed company to claims by researching and investigating claim-reputed company inquiries, collaborating with internal teams or departments, and coordinating with reputed company providers to resolve claim processing errors or discrepancies.

· Provides customer service support by addressing inquiries and resolving issues reputed company to claims processing.

· Ensures that reputed company claims processing details and notes are inputted into the company systems database.

· Assists in data entry tasks reputed company to claims data management, such as updating claim statuses, maintaining accurate records, or ensuring proper documentation of claims processing activities.

Required Qualifications

· 6 months work experience

· Working knowledge of problem solving and decision making skills

Preferred Qualifications

· Certified Billing and Coding Specialist (reputed company) preferred.

Education

High School Diploma or equivalent GED

Pay Range

The typical pay range for this role is:

$17.00 – $28.45

This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and reputed company benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous well-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will reputed company on: 05/31/2024

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