Processor, Claims II Position Available In Richland, South Carolina
Tallo's Job Summary: The Processor, Claims II position offers a pay rate of $15.50/hr, with a Mon-Fri schedule from 8:00 AM - 4:30 PM. Responsibilities include claims processing, quality assurance, and research & resolution. Required qualifications include a High School Diploma and 2 years of claims processing experience. Preferred candidates have 5 years of experience in processing and adjudicating claims.
Job Description
Description- Pay Rate:
$15.50/hr
Schedule:
Mon-Fri, 8:00 AM – 4:30
PM Training:
6-week training period
Daily Responsibilities:
Claims Processing (70%): Examine and process complex or specialty claims based on business/contract regulations, internal standards, and examining guidelines. Enter claims into the system after verifying correct coding of procedures and diagnosis codes. Ensure claims are keyed correctly. Quality Assurance (15%): Ensure claims are processed according to established quality and production standards. Correct processing errors by reprocessing, adjusting, and/or recouping claims. Research and Resolution (15%): Research and resolve claims edits and deferrals. Utilize policies, procedures, reference materials, and forms to perform research on claim problems. Coordinate with various internal support areas and respond to routine correspondence. Complete spreadsheets if applicable.
Additional Skills & Qualifications:
Required Education:
High School Diploma or equivalent
Required Work Experience:
2 years of experience in processing, researching, and adjudicating claims
Preferred Work Experience:
5 years of experience in processing and adjudicating claims
