Blue Cross Blue Shield of North Dakota · 1 day ago
Senior Claims Advocate (Medicaid Expansion)
Fargo, North Dakota, United States
Full-time
Hybrid
Senior Level
$20.32/hr - $32.52/hr
5+ years expBlue Cross Blue Shield of North Dakota is committed to providing personalized service and access to care for North Dakotans. The Senior Claims Advocate is responsible for reviewing complex health insurance claims and inquiries, determining the appropriate actions to take, and ensuring compliance with organizational policies and procedures.
Health Care
No H1B
U.S. Citizen Only
Responsibilities
Reviews claim inquiries by analyzing, interpreting, and researching the request to determine appropriate action
Utilizes various systems and process guidelines to review, process, and adjudicate claims, ensuring quality and timeliness standards are met
Initiates requests to update member information, when necessary
Achieves and maintains a clear understanding of all systems, applications, and procedures necessary to identify denial codes, edits, and processing codes pertaining to all claims in order to process claims correctly
Responds to incoming reports, medical records, and other related documents to make claim determinations for additional processing
Performs research on claims history, contract benefits, or other relevant documentation to process outstanding claims and make determinations on how to move the claim through the process
Performs work under minimal supervision. Handles complex issues and problems and refers more complex issues to higher-level staff
Coaches and mentors department staff and collaborates with leadership to support strategic goals within the team
Qualification
Required
A high school diploma, or GED, is required
A minimum of 5 years of experience in claims processing, insurance, or related work
Demonstrates advanced attention to detail and accuracy
Maintains strong task and goal focus
Applies advanced problem-solving and resolution skills
Communicates effectively, both verbally and in writing
Adapts flexibly to changing priorities and environments
Builds effective interpersonal relationships and communicates well with others
Equivalent combination of education, experience or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards
Benefits
Affordable medical, dental and vision coverage accepted throughout the United States
Employer funded Lifestyle Spending Accounts and Health Savings Accounts. Voluntary employee contributions to Health Savings Accounts and Flexible Spending Accounts
Employer-paid life and disability insurance
401(k) retirement plan with company match and immediate vesting
Paid holidays, paid time off (PTO), PTO donation program, and paid parental leave
Voluntary benefits including Accident, Hospital Indemnity, Critical Illness, Term/Whole Life, Cancer Care Insurance, and more
Robust mental health offerings including an Employee Assistance Program, Learn to Live, meQ.
Comprehensive learning and development opportunities and an Educational Assistance Program.
16 hours of paid volunteer time with a $200 donation to a charity of your choice upon completion of all volunteer hours.
Employee recognition, community initiative events and yearly company outings.
Workplace flexibility offering different options for working arrangements and the freedom to make time for important commitments.
Opportunities to connect through employee committees.
Company
Blue Cross Blue Shield of North Dakota
A not-for-profit health insurance company
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Dan Conrad
President & CEO
Recent News
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2025-10-31
2025-09-07
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