What are the responsibilities and job description for the Remote Medical Claims CSR position at TEKsystems?
*SUMMARY:*
Provide call center callers with timely, accurate, and customer-focused claim information, solicit information needed to perfect the claim, consistently deliver a superior level of customer service, document the claim system, work with the Supplemental Health and Limited Medical Benefit products, and perform well in a call center team environment.
*Required Skills & Abilities:*
* Medical claims/Health insurance/Benefits experience is required.
* Knowledge of HFCA 1500 & UB04 forms
* 1 years of related call center or office-based customer service experience
* Ability to recognize CPT & rev cycle codes.
* Must have a high school diploma or GED.
* Proficiency in MS Office applications
*Details:*
* 100% Remote | Equipment Provided. Applicants must provide the internet and a quiet workspace.
* Schedule: Monday to Friday | 8:30am - 5:00pm *(PST)*
* Pay: $18 - $20/hr. based on related experience
* Pay cycle - Weekly | Medical, Dental & Vision Benefits offered.
*Key Responsibilities:*
* Customer Service Calls: Provide customers with timely, accurate, and customer-focused benefit and claim information.
* Solicit and enter the information needed to enter and process claims accurately and in a timely manner.
* Record summaries of information exchanged in our claim system with a high level of accuracy and detail easily understood by the user.
* Issue timely and accurate claim acknowledgement correspondence.
* Process incoming documents with high coding integrity and distribute immediately.
* Remain fully compliant with operational standards.
* Meet or exceed call center operational metrics.
* Claims Registration: Enter incoming claims information with high degree of accuracy, meeting or exceeding established metrics.
* Comprehensively review and evaluate appeal and complaint requests to identify and classify member and provider appeals.
* Determine eligibility, benefits, and prior activity related to the claims, payment, or service in question.
* Research appeal files for completeness and accuracy and investigate deficiencies.
*Pay and Benefits*
The pay range for this position is $20.00 - $20.00
* 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 remote position.
*Application Deadline*
This position will be accepting applications until Jan 20, 2025.
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Provide call center callers with timely, accurate, and customer-focused claim information, solicit information needed to perfect the claim, consistently deliver a superior level of customer service, document the claim system, work with the Supplemental Health and Limited Medical Benefit products, and perform well in a call center team environment.
*Required Skills & Abilities:*
* Medical claims/Health insurance/Benefits experience is required.
* Knowledge of HFCA 1500 & UB04 forms
* 1 years of related call center or office-based customer service experience
* Ability to recognize CPT & rev cycle codes.
* Must have a high school diploma or GED.
* Proficiency in MS Office applications
*Details:*
* 100% Remote | Equipment Provided. Applicants must provide the internet and a quiet workspace.
* Schedule: Monday to Friday | 8:30am - 5:00pm *(PST)*
* Pay: $18 - $20/hr. based on related experience
* Pay cycle - Weekly | Medical, Dental & Vision Benefits offered.
*Key Responsibilities:*
* Customer Service Calls: Provide customers with timely, accurate, and customer-focused benefit and claim information.
* Solicit and enter the information needed to enter and process claims accurately and in a timely manner.
* Record summaries of information exchanged in our claim system with a high level of accuracy and detail easily understood by the user.
* Issue timely and accurate claim acknowledgement correspondence.
* Process incoming documents with high coding integrity and distribute immediately.
* Remain fully compliant with operational standards.
* Meet or exceed call center operational metrics.
* Claims Registration: Enter incoming claims information with high degree of accuracy, meeting or exceeding established metrics.
* Comprehensively review and evaluate appeal and complaint requests to identify and classify member and provider appeals.
* Determine eligibility, benefits, and prior activity related to the claims, payment, or service in question.
* Research appeal files for completeness and accuracy and investigate deficiencies.
*Pay and Benefits*
The pay range for this position is $20.00 - $20.00
* 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 remote position.
*Application Deadline*
This position will be accepting applications until Jan 20, 2025.
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Salary : $18 - $20
