Job Title: Claims Processor

Job Description

As a Claims Processor, you will support the achievement of member outcomes and goals by delivering exceptional support services to employees, providers, members, and other stakeholders. Your role will involve identifying and participating in efforts to continuously improve the quality of support services, while understanding and contributing to our member-centered culture.

Responsibilities

• Accurately keys claims data into the claims processing system and resolves routine edits up to assigned complexity, according to established Claims Department policies and procedures.
• Performs assigned workload within established timeframes to assure Claims turnaround time goals are met.
• Resolves issues before claims payment to avoid re-adjudication.
• Refers complex claims or claims falling out of standard policies and procedure guidelines to Team Leader.
• Performs other duties as assigned.
• Protects privacy and maintains confidentiality of sensitive employee, participant, and agency information.
• Meets departmental performance goals, which are measured by meeting claims turnaround time, individual productivity, quality, and accuracy of work completed.

Essential Skills

• Experience with healthcare, insurance, Medicaid, and Medicare.
• Familiarity with electronic health records (EHR) and electronic medical records (EMR).

Additional Skills & Qualifications

• Strong understanding of healthcare systems and insurance processes.
• Ability to identify and implement improvements in operational processes.
• Excellent data entry skills and attention to detail.

Pay and Benefits

The pay range for this position is $19.00 - $24.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Waukesha,WI.

Application Deadline

This position is anticipated to close on Feb 4, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Salary : $19 - $24