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SalaryClaims Examiner I
Who are we?
Versant Health is one of the nation’s leading administrators of managed vision care, serving millions of our clients’ members nationwide. We are driven by our mission to help members enjoy the wonders of sight through healthy eyes and vision.
As a Versant Health associate, you can enjoy a comprehensive Total Rewards package, which includes health and dental insurance, tuition reimbursement, 401(k) with company match, pet insurance, no-cost-to-you vision insurance for you and your qualified dependents. We are also invested in your success. There are many opportunities for advancement and development throughout all stages of your career with us.
See how you can make a difference with the support of strong leadership and a team environment.
See Everything, Be Anything™.
What are we looking for?
The Claims Examiner I is responsible for researching unidentified claims, returning claims to providers, correcting errors for WEB, EDI, Paper claims, and other special projects.
Where you will have an impact
- Researching unidentified claims
- Correcting errors for WEB, EDI and Paper claims
- Researching provider mismatch
- Researching member mismatch
- Returning claims to Providers/Members for additional information
- Working reports
- Meets required performance guarantee deadlines, company objectives and production and quality standards
- Adheres to privacy and confidential and proprietary company policies and procedures (i.e. HIPAA)
- Participates in any/all training and educational activities necessary to fulfill at least the minimum requirements as specified within your departmental goals
- Complete any activities necessary for the maintenance of professional affiliations or organizational requirements
- Diligently maintains and safeguard data, cleanliness of all equipment, workstations and the overall care of all equipment on a daily basis
- As required by changing business needs, completes additional responsibilities as assigned
- Regular reliable attendance is required
- Minimum High School Diploma or GED
- One year of office experience preferred
- Knowledge of International Classification of Diseases (ICD), Healthcare Common Procedure Coding System (HCPCS) and/or Current Procedural Terminology (CPT) codes preferred
- Health Insurance experience preferred
- Proficiency in Microsoft Office
All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures. As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times. As a result, Associates must explicitly adhere to all data security guidelines established within the Company’s Privacy & Security Training Program.
Versant Health will never request money from candidates who seek employment with us and will never ask for any payment as part of the recruitment process.
Versant Health is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce. All qualified applicants will receive consideration for employment at Versant Health without regards to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, national origin, marital or domestic/civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law.
The wage range for applicants for this position is [$19.00 to $20.87].
All incentives and benefits are subject to the applicable plan terms.
