What are the responsibilities and job description for the Claims Processor position at Pyramid?
- Medical Claims Processing - Accurately review, verify and process insurance claims following the company policies/SOPs.
- Documentation Review - Analyze claim documents, medical records, benefit summary to determine claim eligibility and process the claim as per the benefit.
- Customer and Internal Business Partner Interaction - Communicate with member, healthcare providers and internal business partners to resolve the claim or gather required additional information.
- Data Entry - Enter claim details and maintain accurate records within the claims management system.
- Problem resolution - Investigate discrepancies and resolve disputes related claim processing
- Rework Adjustment Experience - Should be able to perform the rework adjustment basis the provider request and internal rework/adjustment requirement.
- Continuous improvement - Identify process improvement opportunities to enhance claims accuracy and efficiency.
Job Types: Full-time, Contract, Temporary
Pay: $16.00 - $18.00 per hour
Expected hours: 40 per week
Benefits:
- Dental insurance
- Health insurance
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Experience:
- Medical claims: 2 years (Preferred)
- Documentation review: 2 years (Preferred)
- Insurance verification: 2 years (Preferred)
Work Location: Hybrid remote in Tampa, FL 33634
Salary : $16 - $18
