Claims Processor

About the position

The Claims Processor will be responsible for reviewing claims for accuracy, completeness, and eligibility. The Claims Processor is responsible for adjudicating claims, completing work assignments, and meeting established departmental metrics.

What you will be doing

• Data entry of claims into system.
• Review, analyze, and adjudicate claims.
• Validate the information on all claims to ensure there is no missing or incomplete information.
• Able to understand and apply benefits as outlined in the plan document.
• Maintain and manage all claim inventories in accordance with health plan and regulatory policies.
• Display maturity, composure, and ability to operate under stressful conditions.
• Complete daily assignments and update required spreadsheet.
• Complete end-of-day summary.
• Flexibility to change work direction as determined by management.
• Meet departmental standards for quality, production, and attendance.
• Analyst is flexible and able to commit to overtime based on business needs.
• Other duties as required.

What you need

• Associates degree preferred.
• 2+ years claims processing self-funded claims.
• Strong analytical, research, and communication skills.
• Expansive knowledge of medical terminology.
• Excellent verbal and written communication skills as well as exemplary organizational skills.
• Work closely with leadership to assist in mitigating trends as necessary.
• Independent judgment in decision-making and problem-solving.
• Computer skills in MS Word, Excel, PowerPoint, & Outlook at the intermediate or higher level.
• Ability to multi-task & anticipate potential needs/problems.
• Strong attention to detail.
• Ability to understand and apply on-line documentation policies and procedures.
• Excellent customer service skills including an ability to follow through, take ownership, and drive all assigned tasks to completion.
• Ability to handle large volumes of work, solve problems, and manage multiple assignments while meeting critical deadlines.
• HIPAA Compliance.

Work requirements

• Fast-paced, dynamic work environment requiring the ability to be adaptive, innovative, and flexible.
• Travel minimal.

Why work at Marpai?

• Generous PTO.
• Medical and Prescription.
• EAP.
• FSA / HSA / Dependent Care.
• Dental.
• Vision.
• Life and Disability.
• STD/LTD.
• Voluntary Benefits: Critical Illness, Accident, Hospital.
• 401k with Employer Match.
• LegalShield.
• Identity Theft Protection.

Compensation

$24.00 - $30.00 per hour.

Additional Information

This is a remote position.