Claims Processor, Brio Living Services

Schedule: Full Time | 40 hours per week
Location: Ypsilanti, MI, or surrounding areas
Work Type: Remote position with onsite requirements (training will be conducted onsite)

The Claims Processor analyzes, supports, and executes functions within the claims adjudication process for PACE Shore-to-Shore (S2S), including LifeCircles PACE, Huron Valley PACE, and Thome PACE.

What you’ll do:

Claims Adjudication Process

• Verifying proper authorizations and documentation before processing claims, with necessary follow-up
• Data entry for claims processing
• Tracking claim status and communicating with vendors
• Handling claims denials

Claims Data Tracking and Reporting

• Track and assist in reporting claims data for re-insurance and other key areas as assigned
• Assist with monthly correspondence for True Out of Pocket (TOOP) cost tracking
• Support monthly RAPs and EDS reporting, including resolving claim errors
• Participate in monthly audits of RAPs return/output data

Team Collaboration and Skill Development

• Actively participate in team meetings and training opportunities to stay current and enhance professional skills

Regulatory Compliance

• Brio Living Services policies and safety guidelines
• Federal, state, and local regulatory requirements

This is a summary of the position, and it is not intended to be an exhaustive list of all duties. If selected for the position, you will receive a complete job description.

What It Takes:

• Associate Degree in Business, Accounting, Finance, or a related field, desired.
• A combination of education and directly related experience may be considered.
• Two years of previous financial experience.
• Strong technology skills, including proficiency in computers, Microsoft Office (Word, Excel, Outlook), data entry, and system applications.

Why Brio Living Services?

• Make an impact on the lives of older adults.
• Comprehensive benefits, including Medical, Vision, and Dental Insurance, Retirement Savings Plan, and Wellness Program with Reimbursement.
• Generous paid time off, 6 Paid Holidays, and 2 Floating Holidays.
• Growth opportunities, including an Educational Scholarship Program and Tuition Reimbursement.

Req #: 9528

Accessibility Support

Brio Living Services is committed to offering reasonable accommodation to job applicants with disabilities. If you need assistance or an accommodation, please contact us at loveyourcareer@mybrio.org.

Brio Living Services is an Equal Opportunity Employer
We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, or genetics, in accordance with federal, state, and local laws.

BENLNCIJ