What are the responsibilities and job description for the Claims Processor position at Managed Staffing?
Job Description
Job Description
Remote or Onsite : Onsite o If onsite, please indicate if hybrid or workplace only for first few months will be workplace only with possible hybrid opportunity with 3 days office and 2 days remote - possible not guaranteed REASON FOR REQUEST : Temporary Resource to support a Medically Necessary Contacts Processing GENERAL FUNCTION : Accurately and efficiently processes manual claims and other simple processes such as claims projects. Through demonstrated experience and knowledge, process standard, non-complex claims requiring a basic knowledge of claims adjudication. MAJOR DUTIES & RESPONSIBILITIES : Processing - Efficiently and accurately processes standard claims or adjustments Consistently achieves key internals with respect to production, cycle time, and quality May participate on non-complex special claims projects initiatives, including network efforts Understands and quickly operationalizes processing changes resulting from new plans, benefit designs. Drive client satisfaction - Works with supervisor and co-workers to provide strong customer service and communication with key customer interfaces that include EyeMed Account Managers, Operations, Information Systems, Client Representatives and EyeMed leadership team Drives Key Performance Indications - Consistently meets or exceeds agreed upon performance standards in both productivity and accuracy Proactively works with supervisor to develop self-remediation plan when standards are not being met KNOWLEDGE & SKILLS : Data entry and claims processing knowledge Has a working knowledge of interface systems that include the EyeMed claims system, Metastorm, Exclaim and EyeNet Some basic working knowledge of software programs, specifically Excel and Access Understands third party benefits and administration Strong customer service focus Ability to work well under pressure and multi-task EXPERIENCE : 0-1 years of claims processing / data entry experience. Knowledge of PCs and spreadsheet applications EDUCATION : High school mandatory There will actually be 5 courses that required for all temporary employees : 3 for Compliance purposes and 2 for HiTrust / Security requirements : 1. General Compliance 2. HIPAA 3. Fraud, Waste, and Abuse 4. Security Essentials 5. Introduction to Phishing In addition; Model of Care, ODAG, FSL Fraud Integral Staff training, CA Fair Claims.
Hours : 8 : 00am to 5 : 00pm
