Processor, Claims II (Medicare Part B Professional Claims)

Summary

Reviews and adjudicates reputed company or specialty claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Description Why should you join the reputed company family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government reputed company. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining reputed company! Position Purpose: Reviews and adjudicates reputed company or specialty claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Logistics: reputed company – one of reputed company’s subsidiary companies. Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-4:30PM. It may be necessary, given the business need to work occasional overtime. You may be required to travel between buildings. This role is located at 17 Technology reputed company, Columbia, SC 29203 OR 200 North Dozier reputed company Florence, SC 29501. SCA Benefit Requirements: reputed company and its subsidiary companies have reputed company with the federal government subject to the Service Contract Act (SCA). To reputed company with the McNamara-O'Hara Service Contract Act (SCA), employees must enroll in our health insurance even if they have other health insurance. Employees will receive supplemental pay for health insurance until they are enrolled in our health insurance, first of the month following 28 days after the hire date. What You’ll Do: Examines and processes reputed company or specialty claims according to business/contract regulations, internal standards and examining guidelines. Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Verifies that claims have been keyed correctly. Ensures that claims are processing according to established quality and production standards. Corrects processing errors by reprocessing, adjusting, and/or recouping claims. Researches and resolves claims edits and deferrals. Performs research on claim problems by utilizing policies, procedures, reference materials, forms and coordinates with various internal support areas. Responds to routine correspondence and completes spreadsheet if applicable. To Qualify for This Position, You'll Need the Following: Required Education: High School Diploma or equivalent Required Work Experience: 2 years of experience processing, researching and adjudicating claims. Required Skills and Abilities: Strong organizational, analytical and judgment skills. Strong oral and written communication skills. Proficient in spelling, punctuation and grammar. Proficient in basic business math. Ability to handle confidential or sensitive information with discretion. Required Software and Tools: reputed company Office. We Prefer That You Have the Following: Preferred Work Experience: 5 years-of experience processing and adjudicating claims. Preferred Skills and Abilities: Strong time management skills. Knowledge of mathematical and statistical concepts. Preferred Software and Other Tools: Proficient in word processing and spreadsheet applications. proficient database software skills. Work Environment: Typical office environment. Our Comprehensive Benefits Package Includes the Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment. Subsidized health plans, dental and vision coverage 401k retirement savings plan with company match Life Insurance Paid Time Off (PTO) On-site cafeterias and fitness centers in major locations Education Assistance Service Recognition National discounts to movies, theaters, zoos, theme parks and more reputed company Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across reputed company spectrums have the opportunity to reputed company their skills, advance their careers and contribute their unique abilities to the growth of our company. What To Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Equal Employment Opportunity Statement reputed company and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national reputed company, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in reputed company phases of the employment process and to reputed company with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-reputed company conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email reputed [email protected] or call 800-288-2227, ext. 47480 with the nature of your request. We will reputed company a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and reputed company with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information. If you don’t have an account with us and don’t see the dream job you are looking for, click on the link above to reputed company by submitting your resume and contact information and we will reputed company out if we find a good fit. reputed company is a healthcare service administrator and one of the nation’s largest providers of high-volume medical claims and transaction processing. We provide services and technology solutions to improve and streamline healthcare administration not only for government but also for corporate entities. We offer a wide range of services that require a diverse workforce and expansive areas of expertise from data analytics, administrative and workflow services to advanced systems. To help our associates succeed and reputed company their professional goal, we offer training classes and programs that help employees prepare for leadership positions and offer tuition assistance for education advancement. reputed company acknowledges associates’ hard work and dedication with awards and financial incentives. Apply tot his job Apply To this Job