Claims Processor, Brio Living Services

UMRC & Porter Hills; Chelsea (MI); Remote; USD 40,000 - 70,000; Full time

Job summary

An established industry player is seeking a Claims Processor to join their dynamic team. This role offers the opportunity to engage in the claims adjudication process, ensuring accuracy and compliance while providing essential support to various PACE programs. You will be responsible for verifying documentation, tracking claims, and collaborating with team members to enhance your skills. With a commitment to career growth, this position offers competitive benefits, including tuition assistance and a wellness program. If you are detail-oriented and passionate about making a difference, this is the perfect opportunity for you!

Benefits

Tuition Assistance

Wellness Program Reimbursement

Medical, Vision & Dental Insurance

Retirement Savings Plan

Daily Pay

Generous Paid Time Off

Referral Bonus Program

Mileage Reimbursement

Qualifications

• Two years of financial experience required.
• Proficiency in Microsoft Office is essential.

Responsibilities

• Verify authorizations and documentation for claims processing.
• Track claims data and assist in reporting.

Skills

Data Entry

Claims Processing

Communication Skills

Technology Skills

Regulatory Compliance

Education

Associate Degree in Business

Accounting or Finance Degree

Tools

Microsoft Office

System Applications

Job description

Join our Team as a Claims Processor!

Why You’ll Love Working Here:

• Career Growth & Development – Advance your career with tuition assistance and school scholarships up to $3,000 per semester.
• Wellness Program & Reimbursement – Prioritize your health and well-being, reimbursed $120 a year!
• Competitive Benefits for Full-Time Team Members – Enjoy Medical, Vision & Dental Insurance starting on the 1st of the month after 30 days of hire.
• Retirement Savings Plan – Secure your future with employer contributions.
• Daily Pay – Get paid when YOU want!
• Generous Paid Time Off (PTO) – Includes 6 Paid Holidays and 2 Floating Holidays.
• Team Member Referral Bonus Program – Earn $500 when you bring great people to our team!
• Mileage Reimbursement – Offered for work-related travel.

Schedule: Full Time | 40 hours per week

Department: Ypsilanti, MI and surrounding areas

Work Type: Remote position with onsite requirements (training will be conducted onsite)

What You’ll Do in This Role:

The Claims Processor analyzes, supports, and executes functions within the claims adjudication process for PACE Shore-to-Shore (S2S), including LifeCircles PACE, Huron Valley PACE, and Thome PACE.

Primary Responsibilities:

Claims Adjudication Process

• Verifying proper authorizations and documentation before processing claims, with necessary follow-up.
• Data entry for claims processing.
• Tracking claim status and communicating with vendors.
• Handling claims denials.

Claims Data Tracking and Reporting

• Track and assist in reporting claims data for re-insurance and other key areas as assigned.
• Assist with monthly correspondence for True Out of Pocket (TOOP) cost tracking.
• Support monthly RAPs and EDS reporting, including resolving claim errors.
• Participate in monthly audits of RAPs return/output data.

Team Collaboration and Skill Development

• Actively participate in team meetings and training opportunities to stay current and enhance professional skills.

Regulatory Compliance

• Brio Living Services policies and safety guidelines.
• Federal, state, and local regulatory requirements.

What You’ll Need:

• Associate Degree in Business, Accounting, Finance, or a related field, desired.
• A combination of education and directly related experience may be considered.
• Two years of previous financial experience.
• Strong technology skills, including proficiency in computers, Microsoft Office (Word, Excel, Outlook), data entry, and system applications.

The above is a summary of the position, it in no way states or implies that these are the only duties this position will be required to perform. If selected for the position you will receive a full job description.

Ready to Make an Impact?

At Brio Living Services, we’re looking for compassionate, dedicated individuals who are ready to contribute to a supportive and dynamic team. If this sounds like you, we’d love to have you join us!

Apply today and let’s build a healthier future together!

ACCESSIBILITY SUPPORT

Brio Living Services is committed to offering reasonable accommodation to job applicants with disabilities. If you need assistance or an accommodation due to disability, please contact us at [e-mail]

BRIO LIVING SERVICES IS AN EQUAL OPPORTUNITY EMPLOYER

Brio Living Services provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, or genetics in accordance with applicable federal, state and local laws.

Req# 9709