Remote Claims Specialist I

Arkansas Blue Cross Blue Shield; United States; Remote; USD 42.000 - 66.000; Vollzeit

Zusammenfassung

Arkansas Blue Cross Blue Shield is seeking a Claims Specialist to resolve non-auto adjudicated medical claims with precision and speed, in line with divisional standards.

The role involves data entry, benefit interpretation, and coordinating with providers to obtain missing information while maintaining service quality during peak periods and system downtime.

You will contribute to process improvements, stay current with ICD/CPT coding, and work remotely from multiple states in the U.S.

Qualifikationen

• High School diploma or equivalent.
• Two years of college coursework (48 sem. hrs) or related certification in anatomy, medical terminology, math, or biology.
• Or at least one year of related office experience such as claims processing, health insurance, or medical office.
• Must pass company proficiency test: Claims Assessment

Aufgaben

• Claims Processing: pay or deny pended claims, enter data, review and interpret contract benefits, conduct edit and audit resolution, determine benefit eligibility.
• Identify and research processing issues through systems and manuals; route claims to other areas; consult internal staff and medical providers; generate correspondence; complete forms to obtain necessary information.
• Other duties: As assigned

Jobbeschreibung

Arkansas Blue Cross Blue Shield is seeking a Claims Specialist to resolve non-auto adjudicated medical claims with precision and speed, in line with divisional standards.

The role involves data entry, benefit interpretation, and coordinating with providers to obtain missing information while maintaining service quality during peak periods and system downtime.

You will contribute to process improvements, stay current with ICD/CPT coding, and work remotely from multiple states in the U.S.