Remote Medical Claims Specialist I

Arkansas Blue Cross and Blue Shield; Little Rock (AR); Remote; USD 27,000 - 35,000; Full time

Job summary

Arkansas Blue Cross and Blue Shield is seeking a Claims Specialist to resolve medical claims not automatically adjudicated by our processing system. You will work to complete claims accurately and timely, perform investigation when needed, and communicate with providers to obtain necessary information.

The role is remote with preference for candidates in Arkansas and nearby states. Requirements include a high school diploma and at least one year of related office experience or two years of

Qualifications

• High School diploma or equivalent.
• Two years college coursework (48 semester hours) or related certification with emphasis in anatomy, medical terminology, math, biology, or a related field; OR one year of related office experience.
• Must pass company proficiency test: Claims Assessment

Responsibilities

• Claims Processing: enter data, review contracts, resolve edits, determine benefit eligibility, research issues, route claims to other areas, and generate correspondence.
• Support continuous learning: undergo training, access relevant systems, and stay current with processing procedures and standards.
• Other duties as assigned

Skills

Oral & Written Communications

Strong Interpersonal skills

Sound Judgement

Decision Making

Detail-Oriented

Teamwork

Dependability

Clinical Judgment

Time Management

Education

High School diploma or equivalent

Two years college coursework (48 semester hours) or related certification in anatomy/medical terminology/math/biology

One year of related office experience (claims processing/health insurance/medical office)

Must pass Claims Assessment proficiency test

Job description

Arkansas Blue Cross and Blue Shield is seeking a Claims Specialist to resolve medical claims not automatically adjudicated by our processing system. You will work to complete claims accurately and timely, perform investigation when needed, and communicate with providers to obtain necessary information.

The role is remote with preference for candidates in Arkansas and nearby states. Requirements include a high school diploma and at least one year of related office experience or two years of