At Coventry, we've been building a world-class Customer Service Organization that delivers an easy and simple experience for our customers. We need the right people on the front line to make a difference with our members, health care providers and even each other as we work together as a team.
If you are looking for a career in the health care industry, but prefer an office environment, this could be the right opportunity for you. We are currently recruiting a Claims Specialist in our Newark, DE Service Center. The ideal candidate will be responsible for interfacing with customers via telephone to respond to routine inquires and resolve concerns and servicing customers by processing claims and adjustments accurately and timely.
We offer a competitive salary, excellent benefits (401K with company matching, paid training, comprehensive benefits including medical, dental, tuition reimbursement), vacation and sick time, and a business casual environment. This is a fast-paced, hands-on, team-oriented environment where creativity, initiative, and innovation are highly rewarded.
ESSENTIAL RESPONSIBILITIES :
- Process paper claims and electronic work queues, including complex HCFA 1500 and UB04.
- Interpret and process adjustments and review basic pended claims to determine the appropriateness of the claim status and takes necessary action based on status.
- Examine information including authorizations, payments, denials, coordination of benefits, eligibility and resolve outstanding issues to achieve customer satisfaction goals.
- Maintains complete accurate documentation of all customer interactions and maintain production levels and quality goals.
- Perform other duties as required.
- High school diploma or equivalent.
- Effective keyboarding skills with a minimum typing requirement of 25 wpm.
- Previous health care related customer service experience in health care products, medical terminology and/or coordination of benefits.
- Basic working knowledge of MS Office.
- Highly self-motivated and able to work well under stress in a fast-paced environment.
- Excellent organizational aptitude and high attention to details.
- Strong listening and interpersonal skills; skilled at developing and maintaining effective working relationships.
- Demonstrates responsiveness and a sense of urgency when dealing with customers.
- Effective verbal and written communication skills.
- Strong analytical and problem-solving skills.
- Strong organizational skills with ability to multi-task well.
- Must be able to absorb and apply new and changing information.
- Possess ability to maintain production levels and quality goals.
- Able to maintain regular and consistent attendance in accordance with company and departmental policies and procedures.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Administrative Support Workers
Primary Location: Newark, DE, US
Other Locations: ,
Organization: 10750 - Service Center - Central Admin
Job Posting: 2013-04-05 00:00:00.0
Job ID: 1311272
In May of 2013, Coventry became a part of Aetna. We are excited to join together with common values and a common mission: empowering people...