What are the responsibilities and job description for the Claims Specialist I position at Paladin Consulting, Inc?
Duties:
Required Skills, Knowledge, and Experience:
- The Claims Specialist resolves medical claims that are not automatically adjudicated by the claims processing system in a timely and accurate manner according to divisional standards of quality and productivity.
- Resolution may include additional investigation or communication in order to obtain necessary information to complete the claim.
- Outside issues such as peak filing season, systems down time, inclement weather, holidays, and absenteeism may directly affect the volume of work for each Specialist
Required Skills, Knowledge, and Experience:
- Written and verbal communications
- Strong Interpersonal skills
- Sound Judgement
- Decision Making
- Detail-Oriented
- Teamwork
- Dependability
- High School diploma or equivalent.
- Two (2) years of college coursework (48 semester hours) or other equivalent certification with an emphasis in anatomy, medical terminology, math, biology, or a related field. OR One (1) year of related office experience such as claims processing, health insurance, or medical office.
- Must pass company proficiency test: Claims Assessment
- OFFICE EXPERIENCE
- CLAIMS
- FILING
- DETAIL-ORIENTED
- CLAIMS PROCESSING
- EXCELLENT WRITTEN AND VERBAL COMMUNICATION SKILLS
- MEDICAL CLAIMS
- OFFICE MEDICAL
Salary : $20
