Arch Staffing
http://www.archstaffingandconsulting.com
http://www.archstaffingandconsulting.com
USD
50000
60000
YEAR
true
Arch Staffing and Consulting in Grand Rapids is seeking a medical insurance claims analyst for one of our clients in the Grand Rapids area.
Responsibilities:
The Claims Analyst is responsible for assisting members and clients with disputes, questions and interpretation of plan descriptions and Plan Documents, as well as processing claims.
Claims Functions:
Customer Service Functions:
Qualifications Required
Education and/or Experience**
License:
Claims Analyst
5300 Patterson Ave. SE , Suite 150 Grand Rapids, MI 49512 US
Posted: 02/27/2022
2022-02-27
2022-09-11
Industry: Administrative and Clerical
Job Number: 7951
Pay Rate: 50000 to 60000
Job Description
Arch Staffing and Consulting in Grand Rapids is seeking a medical insurance claims analyst for one of our clients in the Grand Rapids area.
Responsibilities:
The Claims Analyst is responsible for assisting members and clients with disputes, questions and interpretation of plan descriptions and Plan Documents, as well as processing claims.
Claims Functions:
- Medical /HRA/HSA/Dental/Vision/Flex/STD self-insured claims processing.
- Benefit interpretation of a Summary Plan Description and a Plan Document.
- Knowledge of the vendor role (PBMs, PPOs, Case Management) as it pertains to claims functions.
- Adhere to claims processes and procedures.
- Effectively adjudicate claims and meet quantity and quality standards
- Processing all types (i.e. Coordination of Benefits, Office, Hospital) of claims while meeting department turnaround time standards.
Customer Service Functions:
- Develop and strengthen relationships with members and clients through phone contact and call resolution.
- Effectively utilize all customer service tools available.
- Review and respond to verbal member and provider disputes.
- Take an active role in Claims and Customer Service Meetings.
Qualifications Required
- Ability to create new or modify existing Microsoft Word, Excel reports and documents.
- Superior communication skills, both verbal and written.
- 3-5 years’ experience in the healthcare field which would require knowledge of medical and billing terminology.
- Familiarity with CPT/ICD-10 codes, standard health claim billing forms (UB and HCFA)
- Experience processing all types of claims, such as COB, Medicare, dental, vision, medical, etc., etc.
- Professional conduct at all times with an emphasis on superior customer service.
- Excellent attendance record
- Able to work within a team environment and assisting co-workers when needed.
Education and/or Experience**
- Associates Degree or a combination of education and experience.
- Minimum 2 years’ experience within a call center where customer service and the overall member experience was a priority.
- Knowledge of trends and regulations that impact the healthcare industry.
- Knowledge of Coordination of Benefits and Medicare preferred.
License:
- CPC, CPC-P, CPC-H (Preferred)
- For immediate consideration please forward your resume to this posting or call or text us at 1-844-310-Arch