Remote Claims Specialist I - Detail-Driven and Impactful

Arkansas Blue Cross and Blue Shield; Arkansas; Hybrid; USD 27.000 - 35.000; Vollzeit

Benefits dieser Stelle

Tuition reimbursement

Onsite gym

Green Leaf Grill

Wellness incentives

Zusammenfassung

Arkansas Blue Cross and Blue Shield is seeking a Claims Specialist to resolve non-auto-adjudicated medical claims in a timely and accurate manner, following divisional standards. The role involves data entry, benefit interpretation, and communications with providers to obtain required information.

The position is 100% remote with a preference for Arkansas, Utah, Idaho, and North Dakota residents. Requires a high school diploma and 2 years of college coursework (or equivalent) with proficiency in

Qualifikationen

• High School diploma or equivalent.
• Two years of college coursework (48 semester hours) or equivalent certification with emphasis in anatomy, medical terminology, math, biology, or related field.
• Or minimum one year of related office experience such as claims processing, health insurance, or medical office.
• Must pass claims proficiency test: Claims Assessment.

Aufgaben

• Process claims not auto-adjudicated by entering data and reviewing contract benefits; conduct edit and audit resolution; determine benefit eligibility.
• Identify and research processing issues through systems and manuals; route claims to other areas as needed.
• Consult internal staff and medical providers; generate correspondence and forms to obtain information.

Kenntnisse

Oral & Written Communications

Strong Interpersonal skills

Sound Judgement

Decision Making

Detail-Oriented

Teamwork

Dependability

Clinical Judgment

Computer Work

Critical Thinking

Customer Service

Evaluating Information

Interpersonal Communication

Oral Communications

Organizing

Process Information

Reading Comprehension

Researching

Time Management

Ausbildung

High School diploma or equivalent

Two years college coursework in anatomy, medical terminology, math, biology, or related field

One year of related office experience

Jobbeschreibung

Arkansas Blue Cross and Blue Shield is seeking a Claims Specialist to resolve non-auto-adjudicated medical claims in a timely and accurate manner, following divisional standards. The role involves data entry, benefit interpretation, and communications with providers to obtain required information.

The position is 100% remote with a preference for Arkansas, Utah, Idaho, and North Dakota residents. Requires a high school diploma and 2 years of college coursework (or equivalent) with proficiency in