Essential Functions of Job:
* Processing and evaluating medical and dental claims.
* Obtaining information by telephone as well as by hard copy and entering into the computer systems
* Prioritization of individual work flow associated with the case assignments
* Establishing and maintaining professional rapport with clients and providers (physicians and hospitals)
* Maintaining and assuring accuracy of documentation.
* Meet and/or discuss with members, clients and providers the issues relating to claim administration approximately 25% of the time.
• Must possess excellent skills in benefit interpretation
• Strong mathematical background
• Minimum one to three years experience in processing medical, dental and/or vision claims
• Excellent organizational and prioritization skills
• Proven ability to work in a multi-task fast paced environment
• Proven ability to function as a positive team member
• Must be efficient in Excel and Word with excellent keyboard skills
• High school diploma or equivalent
The Company considers applicants without regard to race, color, national origin, sex, religion, mental or physical disability, marital status, age 40 years and over, sexual preference, veteran's status, or other characteristic protected by applicable law.
Applications for this vacancy will be received for 3 working days after the Posted date from Employees of HealthSCOPE Benefits with more than one year of service.
Applications for this vacancy will be received for 10 working days after the Posted date from External Applicants.