Responsible for all maintenance functions of the on-line Claims Examiner Manual; including research, documentation, updating and monitoring, for all products and lines of business. Ensures all Claims Examiner procedures are compliant with the Member Handbook, Subscriber Contracts and Benefit Interpretation Manual. Frequent interaction with the Claims Processing, Customer Service and System Configuration teams to improve the effectiveness and accuracy of the on-line manual. Develops and revises the processing job aides and guides. Provides technical assistance and subject matter expertise when needed. Conducts and attends informational meetings. Provides assistance with training classes and audit team as needed, may also be assigned to work on special projects and committees. Performs other duties as assigned.
Minimum Education: 2 year college degree and/or combination equivalent background in health insurance or related business experience.
Minimum Experience: Previous medical claim processing experience preferred..
" Excellent written and verbal communication skills
" Strong interpersonal, organizational and analytical skills and attention to detail
" Must be a strong team player accompanied with the ability to work independently
" PC skills required, Microsoft Windows experience highly desired
MVP Health Care - 17 months ago
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MVP Health Plan covers about 650,000 most valuable people. Also known as MVP Health Care, the company provides health insurance and employee...