Precision Claims Processing Specialist

Partnered Staffing - Kelly Services; Florida; On-site; USD 20,664 - 22,041; Full time

Benefits offered by this job

Competitive pay

Paid holidays

Year-end bonus program

Access to continuing education

Insurance options available immediately upon hire

Job summary

A staffing agency is looking for a Claims Specialist to handle claims processing for their client in Lake Mary, FL. The ideal candidate should have a High School Diploma or GED and 1-3 years of Call Center and Reimbursement experience. Responsibilities include verifying claims, communicating with various departments, and adhering to HIPAA regulations. Offers competitive pay and various employee perks such as access to a learning center and insurance options.

Qualifications

• High School Diploma or GED required.
• 1–3 years of experience in a Call Center and Reimbursement setting.
• Proficient in data entry and 10-key skills.

Responsibilities

• Verify submitted claims for completeness and accuracy.
• Process claims according to specific client guidelines.
• Communicate with internal departments and outside agencies regarding claims.

Skills

Data entry proficiency

Knowledge of drugs and drug terminology

Strong communication skills

Analytical skills for fraud detection

Education

High School Diploma or GED

1–3 years of Call Center and Reimbursement experience

Tools

MS Word

Excel

Job description

At Kelly Services, we work with the best. Our clients include 99 of the Fortune 100TM companies, and more than 70,000 hiring managers rely on Kelly annually to access the best talent to drive their business forward. If you only make one career connection today, connect with Kelly.

Job Description

Kelly Services is currently seeking several Claims Specialist for our client's Lake Mary, FL location.

In addition to working with the world’s most recognized and trusted name in staffing, Kelly employees can expect:
Competitive pay
Paid holidays
Year-end bonus program
Recognition and incentive programs
Access to continuing education via the Kelly Learning Center

Pay $15 - $16 per hour
Schedule: Monday through Friday - 9:00am - 6:00pm
Duration: 4 months possible extension (Possible temp - perm)
Anticipated start date: 10/31/2016 to 03/31/2017

SUMMARY
Responsible for various reimbursement functions, including but not limited to accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds, until accounts receivable issues are properly resolved.

MAJOR JOB DUTIES AND RESPONSIBILITIES

Verify member submitted claims forms, member’s eligibility and pharmacy information is complete and accurate, updating system information as needed.
Superior data entry proficiency is expected in order to provide accurate and timely processing of claims submitted by member, pharmacy or appropriate agency.
Moderate knowledge of drugs and drug terminology used daily.
Process claims according to client specific guidelines while identifying claims requiring exception handling.
Navigate daily through several platforms to research and accurately finalize claim submissions.
Oral or written communication with internal departments, members, pharmacies or agencies to resolve claim issues.
Adhere to strict HIPAA regulations especially when communicating to others outside
Prioritize and coordinate influx of daily workload for claims processing, returned mail and out-going correspondence and e-mails to assure required turnaround time is met.
Assess accuracy of system adjudication and alert management of potential problems affecting the integrity of claim processing.
Analyze claims for potential fraud by member or pharmacy.
May be required to work on special projects for claims team.
EDUCATION/EXPERIENCE

High School Diploma or GED Required
1-3 years of Call Center and Reimbursement experience required
Knowledge of completed benefits verifications, submitted test claims, completed or reviewed prior authorizations required
Strong data entry and 10-key skills
Proficient in MS Word and Excel

Additional Information

Why Kelly?

As a Kelly Services candidate you will have access to numerous perks, including:

Exposure to a variety of career opportunities as a result of our expansive network of client companies

Career guides, information and tools to help you successfully position yourself throughout every stage of your career

Access to more than 3,000 online training courses through our Kelly Learning Center

Group-rate insurance options available immediately upon hire*

Weekly pay and service bonus plans

By clicking the link above or any third-party link within this posting, you are leaving this site and going to a third-party website where the third-party website's terms and privacy policy apply