Point C ยท 1 day ago
Claims Examiner
United States
Full-time
Remote
Entry Level
$38K/yr - $41K/yr
1+ years expPoint C is a National third-party administrator (TPA) delivering customized self-funded benefit programs. They are seeking a detail-oriented Claims Examiner responsible for accurately processing medical claims while ensuring compliance with plan documents, policies, and industry regulations.
Health CareHealth InsuranceHospital
Responsibilities
Adjudicate new claims and process adjustments, including denials upon receipt of additional information
Review and resolve appeals and subrogation/third-party liability cases
Manage individual inventory to ensure timely turnaround and production goals are met
Ensure claims are processed in accordance with stop loss contract terms
Respond to internal and external inquiries via email and other channels within established timeframes
Follow up on missing or incomplete information to ensure claims can be accurately processed
Maintain minimum production, financial, and procedural accuracy standards on a monthly basis
Qualification
Required
At least 1+ year of experience in insurance claims processing
Working knowledge of CPT and ICD-10 coding
Basic understanding of medical terminology
Strong communication and customer service skills
Proficiency in Microsoft Office and general computer applications
Ability to maintain confidentiality and comply with all company policies and procedures
Able to work independently with minimal supervision
Ability to prioritize, multitask, and work overtime as needed
Preferred
Associate's degree preferred
Experience with Third Party Administrator (TPA) or self-funded claims administration preferred
Benefits
Comprehensive medical, dental, vision, and life insurance coverage
401(k) retirement plan with employer match
Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)
Paid time off (PTO) and disability leave
Employee Assistance Program (EAP)
Company
Point C
Point C is a network of self-insured healthcare plan third-party administrators.
201-500 employees
Funding
Current Stage
Growth StageTotal Funding
unknownKey Investors
Shore Capital Partners
2024-11-19Series Unknown
Leadership Team
Ben Frisch
Chief Executive Officer
William Mcnally, CPA
Chief Financial Officer
Recent News
Venture Capital Access Online
2024-11-21
2024-02-03
2024-01-04
Company data provided by crunchbase