Remote Claims Specialist I – Detail-Oriented Problem Solver

01 USAble Mutual Insurance Company; United States; Remote; USD 28,000 - 36,000; Full time

Job summary

Arkansas Blue Cross and Blue Shield is seeking a Claims Specialist to resolve non-auto-adjudicated medical claims in a timely, accurate manner according to divisional standards. This role involves data entry, reviewing contract benefits, and investigating issues to complete claims.

Candidates should have at least a high school diploma and either 2 years of college coursework or 1 year of related office experience, plus the ability to pass the Claims Assessment test.

Qualifications

• High school diploma or equivalent required.
• 2 years of college coursework in anatomy, medical terminology, math, biology, or related field, or 1 year of related office experience.
• Must pass Claims Assessment proficiency test.

Responsibilities

• Process pended claims not auto-adjudicated, including data entry and benefit interpretations.
• Research processing issues, consult internal staff and providers, and generate needed forms.
• Maintain adherence to productivity and quality standards.

Skills

Oral Communication

Written Communication

Interpersonal Skills

Detail Orientation

Judgment & Decision Making

Teamwork

Dependability

Customer Service

Time Management

Organizing

Education

High School diploma or equivalent

2 years college coursework / 48 semester hours

Job description

Arkansas Blue Cross and Blue Shield is seeking a Claims Specialist to resolve non-auto-adjudicated medical claims in a timely, accurate manner according to divisional standards. This role involves data entry, reviewing contract benefits, and investigating issues to complete claims.

Candidates should have at least a high school diploma and either 2 years of college coursework or 1 year of related office experience, plus the ability to pass the Claims Assessment test.