Verification Clerk

Louisiana Blue; Baton Rouge (LA); On-site; USD 21,000 - 28,000; Full time

Job summary

Louisiana Blue is seeking a Claims Data Entry Clerk to validate OCR data for claims and correct any discrepancies. The role involves researching claim images, entering omitted data, and ensuring compliance with business rules.

You will report to the Supervisor, Claims Operations and collaborate with the Claims Intake team. Requires a high school diploma and at least 6 months of clerical experience; medical coding background is a plus.

Qualifications

• High School Diploma or equivalent is required.
• 6 months of Clerical experience is required.
• A medical coding diploma may be used in lieu of the six months of experience.
• Completion of the Medical Assistant, Coding & Insurance Pathway from BRCC, can be used in lieu of the six months of experience.
• Medical coding experience is preferred.

Responsibilities

• Confirms that all data extracted is correct and complete to finalize adjudication.
• Maintains accurate reporting of work to track productivity.
• Cross-trains to learn new functions and assist with processing of claims.

Skills

Ten-key data entry

Critical thinking

Medical terminology

Verbal communication

Written communication

Organizational skills

MS Office

Education

High School Diploma

Tools

MS Word

Excel

Job description

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with us.

Residency in or relocation to Louisiana is preferred for all positions.

Applicants must be authorized to work for Louisiana Blue in the United States without employer-sponsored immigration support. Louisiana Blue will not provide current or future employment-based immigration sponsorship or other immigration support for this opportunity, including H-1B, L-1, O-1, H-1B1, E-3, TN, or J-1 sponsorship or F-1 OPT/STEM OPT/CPT support. Applicants who would require such sponsorship or employer support during their employment should not pursue this opportunity.

POSITION PURPOSE

Confirms that all required claim data extracted through OCR is correct and complete. Responsible for researching claim image to correct questionable characters and fields that do not conform to business rules and for entering omitted data. Accountable for complying with all laws and regulations associated with duties and responsibilities.

NATURE AND SCOPE

• This role does not manage people
• This role reports to this job: SUPERVISOR, CLAIMS OPERATIONS
• Necessary Contacts: In order to effectively fulfill this position, the incumbent must be in contact with: Staff of Claims Intake unit.

Education

• High School Diploma or equivalent is required

Work Experience

• 6 months of Clerical experience is required
• A medical coding diploma may be used in lieu of the six months of experience
• Completion of the Medical Assistant, Coding & Insurance Pathway from BRCC, can be used in lieu of the six months of experience.
• Medical coding experience is preferred

Skills And Abilities

• Fast and accurate 10 key data entry ability is required. Prefer candidates capable of over 8,000 keystrokes per hour.
• Must be able to demonstrate critical thinking and problem solving skills required
• Familiarity with medical and health insurance terminology preferred
• Demonstrated verbal and written communication skills with the ability to interpret and communicate information with tact, diplomacy, patience and professionalism.
• Strong organizational skills is required
• Must have working knowledge of relative software (e.g. Microsoft Office Word, Excel, etc.).

Licenses and Certifications

• None Required

Accountabilities And Essential Functions

• Confirms that all data extracted is correct and complete in order for the claim to complete the adjudication process. Researches claims and enters omitted data. Identifies and redirects misrouted claims.
• Maintains accurate and consistent reporting of work performed to track productivity.
• Cross-trains to learn new functions and procedures to assist with processing of claims.

The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions.

Additional Accountabilities And Essential Functions

• Perform other job-related duties as assigned, within your scope of responsibilities.
• Job duties are performed in a normal and clean office environment with normal noise levels.
• Work is predominately done while standing or sitting.
• The ability to comprehend, document, calculate, visualize, and analyze are required.

PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)

Additional Information

Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the 'My Applications' section in the Candidate Home section of your Workday account.

If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact [e-mail] for assistance.

In support of our mission to improve the health and lives of Louisianians, we encourage the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well‑being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.

We perform background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.

Additionally, we are a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.

JOB CATEGORY: Insurance