Claims Processing Representative I

Ultipro; St. Louis (MO); On-site; USD 42,000 - 54,000; Full time

Job summary

Ultipro in Missouri is seeking a Claims Processing Representative I to independently process claims of low to moderate complexity. You will research and investigate issues such as eligibility denials, provider suspensions, and student eligibility decisions to completion when possible.

The role may escalate to more complex scenarios, requiring careful review, documentation, and collaboration with the Claims Supervisor to ensure accurate and timely resolutions.

Qualifications

• Independent processing of claims of low to moderate complexity.
• Researches and investigates claims issues including eligibility denials, provider suspensions, and student eligibility decisions.

Responsibilities

• Process claims of low to moderate complexity.
• Investigate and resolve eligibility denials, provider suspensions, and student eligibility issues to completion where possible.

Job description

Job Title: Claims Processing Representative I

Job Code: NE1005

Reports To: Claims Supervisor

FLSA Status: Non-Exempt

Last Updated: April 2024

Position Summary

The primary responsibility of the Claims Processing Representative I is to independently process claims of low to moderate complexity. This role researches and investigates claims issues including eligibility denials, provider suspensions, and student eligibility decisions to completion when possible. This position resolves specialty claims or processes with low to moderate complexity and may leverage knowledge and skills to resolve complex claims in a single specialty or process area.

This position may escal...