Personify Health · 2 days ago

Claims Specialist

United States

Full-time

Remote

Entry, Mid Level

$15/hr - $21/hr

2+ years exp

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ConsultingElectronic Health Record (EHR)

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Responsibilities

Maintain quality and procedure standards including compete review and examination of claim to ensure proper handling in accordance with company policies and procedures.

Complete claims task in timely manner and maintain production requirement:

Review and understand plans, documents and vendors. Ensure proper system setup while processing claims. Identify and report to management any potential errors, problems or issues regarding plan documents, claims processing or system setup.

Work stop loss renewal process, as directed by management.

Complete all training requirements in a timely manner, as directed by management.

Understand and enforce company procedures, polices and standards.

Practice good follow up procedures to ensure completion of task and/or inquiries.

Direct client contact, internal staff and vendor support to ensure customer and member satisfaction.

Support management team with projects and special request

Qualification

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Claims ProcessingQicLink SystemHealthcare ExperienceWindowsMicrosoft Office

Required

High School Diploma required

2 years claims processing required

Preferred

Associate’s degree in business preferred

5+ years claims processing in the QicLink system preferred

Healthcare industry experience strongly preferred, specifically in healthcare, health insurance, medical office or clinical experience at a front desk, in billing or admissions

Knowledge of insurance database system a plus

Remote work is possible depending on experience and business needs