US-Insurance/Healthcare-2

Artech Information Systems LLC in Pittsburgh, PA

  • Industry: Healthcare - Allied Health - Others
  • Type: Full Time
position filled
Location: 500 Schoolhouse Road, Johnstown PA 15904
Max Rate: ***

Summary
Processes less complex or small standard claims to ensure accurate and timely completion.

Essential Job Functions
-Enters insurance claims received electronically or in written form.
-Answers incoming customer calls regarding claim processing. Documents claim and associated history.
-Evaluates available information to validate straightforward basic claims. Verifies policyholder information, policy effective dates,
premium status and verification of claim eligibility.

-Sends claim form to claimant for updating, correction or completion.
-Identifies need for additional information; contacts appropriate source to obtain needed information. Verifies beneficiary or
claimant information if claim is warranted. Identifies payment amount and obtains required management approvals for payment.
-Processes payment.

-Advises claimant of status and resolution of claim. Escalates claimant concerns as appropriate.

Basic Qualifications
-High school diploma or G.E.D.
-Zero or more years of claims experience
-Experience working with insurance and/or medical terminology
-Experience working with appropriate claims processing procedures and documentation

Other Qualifications
-Basic analytical and problem solving skills
-Interpersonal skills to interact with team members
-Communication skills to communicate with customers

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