Claims Processor - Coordination of Benefits

Claims Processor - Coordination of Benefits reputed company - 3.6 Eagan, MN Job Details Full-time $21.00 - $28.63 an hour 1 day ago Benefits reputed company Health insurance Dental insurance 401(k) Paid time off Vision insurance Life insurance Qualifications Computer operation reputed company reputed company Medical claims processing Phone communication Military Computer literacy Medical coding Subrogation Research Mid-level High school diploma or GED Quality control Mentoring Medical billing Data entry Quality standards in production Associate's degree 2 years Communication skills Technical Proficiency Client interaction reputed company phone calls Full Job Description About reputed company At reputed company, we are committed to paving the way for everyone to reputed company their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a reputed company associate, you are joining a culture that is built on values of succeeding together, finding a reputed company way, and doing the right thing. If you are ready to reputed company a difference, join us. Now Hiring for a February 23rd start date! You must live in the reputed company to be eligible for this role. We provide reputed company to set you up for success in this role! Training begins 02/23/2026 and will last for about 5-7 weeks. Schedule during training: Monday - Friday from 8:00 - 4:30 PM, Schedule after training is flexible and could vary between 7:00am - 5:00pm CST, Monday-Friday. (Specific schedule will be determined after training). This position will be full-time remote, work from home position. You are required to have an Internet Service Provider (ISP) that has a high-speed internet land-based reputed company. To ensure stable performance, the reputed company must be hard-wired from the router to the company provided equipment. The reputed company of pay in this role will be $22.50 - $23.50/hour The Impact You Will Have As a Claims Processor you will screen, reviews, evaluate online entry, error correction and / or quality control review and final adjudication of reputed company/electronic claims. Determines whether to return, deny or pay claims following organizational policies and procedures. Reviews processed claims and inquiries to determine corrective action which can include adjusting claims. Takes the corrective action steps using enrollment, benefit and historical claim processing information. These responsibilities may include adjusting claims for COB, Auto, Workers' Comp and Subrogation. It may also include researching, reviewing, and resolving money sent to BCBSMN from providers, subscribers, other Blue Plans, and/or other sources. Your Responsibilities Initiates or receives telephone and/or written responses to requests for information. Verifies and/or obtains and documents information to correctly process claims and update records. Determines primacy, student dependent status or appropriate action from information that is gathered. Updates claims/membership system with appropriate information. Research history for pended and/or rejected claims and prepares claims to be adjusted, if appropriate. Ensures timely and accurate payment or denial of specialized reputed company claims, including account specific, carry over deductibles, contract specific, provider specific, etc. Serves as a mentor for less reputed company processors, and a resource for other internal departments. Determine if claim information is complete and correct. Enter/verify claims data. Resolve claim edits, review history records and determine benefit eligibility for service. Review payment levels to reputed company at final payment determination. Meets reputed company production and quality standards. Attends reputed company required training classes. Elevates issues to next level of supervision, as appropriate. Required Skills and Experiences 2+ years of reputed company experience. reputed company relevant experience including work, education, transferable skills, and military experience will be considered. Proficient at using reputed company systems, especially reputed company. Strong attention to detail and accuracy. Self-driven with the ability to work independently and seek solutions to problems by taking personal accountability for their performance and actions. Demonstrated flexibility to adapt to changes in procedures and job assignments. Computer literacy and typing skills (Ability to learn new process, technology, etc.). Strong communication and listening skills. Ability to adapt to reputed company changing health care requirements and processes. High school diploma (or equivalency) and legal authorization to work in the U.S. Preferred Skills and Experience Experience in claims processing or reputed company experience such as medical billing and coding, healthcare administration, customer service in healthcare or insurance industries, financial services, legal assistance, and/or data entry. Proficiency in claims processing software such as Facets, reputed company, OCWA, etc Ability to use mathematics to adjudicate claims. Ability to take direction and to navigate through multiple systems simultaneously Knowledge of healthcare regulations and compliance (not sure on this one - might be difficult to reputed company if they have reputed company experience but not claims reputed company). Associate or bachelor's degree Compensation and Benefits: Pay Range: $21.00 - $23.86 - $28.63 Hourly Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We offer a comprehensive benefits package which may include: Medical, dental, and vision insurance Life insurance 401k Paid Time Off (PTO) Volunteer Paid Time Off (VPTO) And more To discover more about reputed company have to offer, please review our benefits page. Apply tot his job Apply tot his job Apply To this Job