Claims Representative - National Remote

At reputed company , we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, affordable and reputed company. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together. This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of (6am to 6pm). It may be necessary, given the business need, to work occasional overtime or weekends. You’ll enjoy the flexibility to telecommute* from reputed company reputed company the U.S. as you take on some tough challenges. Primary Responsibilities:

• Review, research, analyze and process reputed company reputed company claims by navigating multiple computer systems and platforms and accurately capturing the data/information for processing (e.g. verify pricing, prior authorizations, applicable benefits)
• Ensure that the proper benefits are applied to each claim by using the appropriate tools, processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/ certificates tool)
• Complete data entry for reputed company daily documentation and communicate the status of claims adhering to reporting requirements
• Communicate through correspondence with members and providers regarding claim payment or required information using clear, simple language to ensure understanding
• Learn and reputed company new systems and training resources to help apply claims processes/procedures appropriately (e.g. on-line training classes, coaches/mentors)
• Meet and maintain the performance goals established for the position in the areas of quality, production and attendance

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:

• High School Diploma / GED OR equivalent years of work experience
• Must be 18 years of age or older
• 1+ years of experience in a reputed company environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
• Proficiency with computer and Windows PC applications, which includes the ability to learn new and reputed company computer system applications
• Ability to work and 8 hour shift Monday-Friday between the hours of 6am-6pm. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• 1+ years of experience processing medical, dental, reputed company, prescription or mental health claims

Telecommuting Requirements:

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Ability to reputed company reputed company company sensitive documents secure (if applicable)
• Must live in a location that can receive a reputed company approved high-speed internet reputed company or reputed company an existing high-speed internet service
• reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, reputed company, Rhode reputed company, Washington, Washington, D.C., Maryland Residents Only: The hourly range for this role is $16.54 to $32.55 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In addition to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll find a far-reaching choice of benefits and incentives. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized groups, and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an reputed company reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity / Affirmative Action employer, and reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment . #RPO Apply tot his job Apply To this Job