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Title
Text copied to clipboard!Claims Processor
Description
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We are looking for a detail-oriented and organized Claims Processor to join our team. In this role, you will be responsible for reviewing, processing, and managing health insurance claims to ensure accuracy and compliance with company policies and regulatory requirements. You will work closely with healthcare providers, insurance companies, and clients to resolve discrepancies and facilitate timely claim settlements. The ideal candidate will have strong analytical skills, excellent communication abilities, and a thorough understanding of health insurance procedures and terminology. Responsibilities include verifying claim information, identifying errors or inconsistencies, coordinating with relevant parties to obtain necessary documentation, and maintaining accurate records. This position requires a commitment to confidentiality, accuracy, and customer service excellence. If you are motivated to contribute to a dynamic team and help streamline the claims process, we encourage you to apply.
Responsibilities
Text copied to clipboard!- Review and process health insurance claims accurately and timely.
- Verify patient and provider information for claim validity.
- Identify and resolve discrepancies or errors in claims.
- Communicate with healthcare providers and insurance companies to clarify claim details.
- Maintain detailed records of claims and correspondence.
- Ensure compliance with company policies and regulatory standards.
- Assist in claim audits and reporting.
- Provide excellent customer service to clients regarding claim status.
- Update and maintain claims processing systems.
- Collaborate with team members to improve claims processing workflows.
Requirements
Text copied to clipboard!- High school diploma or equivalent; associate degree preferred.
- Experience in health insurance claims processing or related field.
- Strong attention to detail and organizational skills.
- Proficient in using claims management software and MS Office.
- Good communication and interpersonal skills.
- Ability to handle confidential information with discretion.
- Knowledge of medical terminology and insurance policies.
- Problem-solving skills and ability to work independently.
- Ability to manage multiple tasks and meet deadlines.
- Customer service orientation.
Potential interview questions
Text copied to clipboard!- What experience do you have with health insurance claims processing?
- How do you ensure accuracy when reviewing claims?
- Describe a time you resolved a discrepancy in a claim.
- What software tools are you familiar with for claims processing?
- How do you handle confidential information?
- Can you work effectively under pressure and meet deadlines?
- Describe your communication style when dealing with providers or clients.
- What motivates you to work in claims processing?
