Claims Processor - Full-Time

Medical Associates; Dubuque (IA); Presencial; USD 42 000 - 56 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Health insurance

401k with company match

Flexible Paid Time Off (24 days/year)

Flexible spending accounts (HSA/DCFSA)

Resumo da oferta

Medical Associates is seeking a Claims Processor to join our team in Iowa. The role requires strong communication, Excel skills, and the ability to multi-task in a collaborative environment.

Responsibilities include processing and paying claims, supporting subrogation resolutions, and interpreting health plan benefits for stakeholders. High school diploma or GED and 1–3 years of related experience preferred.

Qualificações

• High school diploma or GED required.
• 1–3 years of related claims processing experience preferred.
• Proficiency in Microsoft Excel and accurate typing required.

Responsabilidades

• Examine, process, calculate, and pay claims after verification of fee schedules and contract benefits.
• Assist Health Care Services and Subrogation Specialist to ensure timely resolution of claims pended for subrogation and medical authorization.
• Possess knowledge of all health plan benefit plans and provide interpretation to members, brokers, providers, and employers.
• Make appropriate adjustments to previously adjudicated claims.

Conhecimentos

Communication

Microsoft Excel

Team collaboration

Typing speed

Formação académica

High school diploma or GED

Ferramentas

Microsoft Office Suite

Descrição da oferta de emprego

Medical Associates Health Plans is looking for a Claims Processor to join our team!

The Position:

On a daily basis, this person will utilize their professional oral and written communication skills along with their ability to collaborate successfully with a team. Additionally, a successful person in this role will be organized and efficient at multi-tasking, may have some prior claims processing experience, and be proficient at Microsoft Excel and typing.

Benefits Package Includes:

• Single or Family Health Insurance with discounted premium rates for wellness program participation.
• 401k with immediate matching (50% on the dollar up to 7% of pay + additional annual Profit Sharing)
• Flexible Paid Time Off Program (24 days off/year)
• Medical and Dependent Care Flex Spending Accounts
• Life insurance, Long Term Disability Coverage, Short Term Disability Coverage, Dental Insurance, etc.

What you'll be doing:

• Examine, process, calculate, and pay claims after verification of fee schedules and contract benefits in compliance with state laws, employer contracts, policies and procedures, and production standards established by the company.
• Assist Health Care Services and Subrogation Specialist to ensure timely resolution of claims pended for subrogation and medical authorization.
• Possess knowledge of all health plan benefit plans and provide interpretation to all constituents including potential members, brokers, members, providers, employers, and staff.
• Make appropriate adjustments to previously adjudicated claims.

Knowledge, Skills and Abilities:

Education - High school diploma or GED required.

Experience - One to three years of similar or related experience.

Other Skills - Familiar with Microsoft Office applications, particularly Word and Excel.