Medical Claims Processor

Medical Claims Processing Specialist

Point Comfort Underwriters, Inc. (PCU) is a fast-growing, forward-thinking organization that is changing the way medical, dental and pharmacy expenses are managed. PCU is not a traditional third-party administrator. The difference is attributable to PCU’s proprietary technology, which is both customizable and scalable. We manage healthcare access and provide claim management services to foreign-born populations residing across the U.S. PCU underwrites travel medical insurance for U.S. and non-U.S. citizens traveling outside their home country.

Full Time/Hybrid position (40 hours per week) Monday-Friday, with 2 days remote after training is completed.

Job Duties:

• Medical, vision and dental claims processing, adjudicating and data entry
• Resolve Medical Claims by approving or denying service lines; calculating benefit due, initiating payment or denial of services rendered.
• Direct contact with business and consumer customers seeking resolution to questions related to PCU administrative services or insurance products
• Ensures legal compliance by following company policies, procedures, and guidelines
• Protects operations by keeping claim information confidential, and following all HIPAA guidelines
• Identify claims related issues and escalate to management for resolution
• Handle service events dealing with residential facilities, answer provider database questions, and perform general customer service
• Telephone, email and fax communication with customers on behalf of company
• Fielding and directing communications to the correct person or department

Job Qualifications:

• High School degree or equivalent required
• Knowledge of medical and healthcare terminology
• Excellent communication and telephone skills required
• Attention to detail
• Enthusiastic, dependable and willing to learn
• Ability to multi task technologically, excellent typing skills and working knowledge of MS Office applications

Qualified Candidates must comply with the following requirements:

• 21 years of age or older.
• Valid driver's license, and reliable transportation to work.
• Good driving history. No DUI, OWI, reckless driving or other major driving infractions
• No felony convictions, drug or weapons violations. No elevated misdemeanor violations.
• Candidates must successfully complete a 10-year FBI background check.
• Candidates must successfully complete a 10-year pre-employment background check.
• Candidates must submit to pre-employment drug screening, and SDI anti-drug program.
• Ability to work with little or no supervision.
• Positive personality traits and a customer service-oriented attitude.

Job Type: Full-time

Pay: $16.00 - $17.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift

Education:

• Associate (Preferred)

Experience:

• Microsoft Office: 1 year (Preferred)
• Medical Claims or insurance: 1 year (Required)

License/Certification:

• Medical Billing and Coding Certification (Preferred)

Work Location: Hybrid remote in Indianapolis, IN 46225