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SalaryPart Time Claims Processor (Troy, MI)
Summary – The Part Time Claims Processor will be responsible for medical, dental, and vision claims processing of claims submitted electronically or on hard copy. The Processor will specialize in a particular group but is expected to handle claims processing for multiple groups.
The Part Time Claims Processor position is a project-specific assignment not expected to last more than 6 months.
Applicants for this remote role will only be considered if they live in these locations: Arizona, California, Colorado, Washington DC, Iowa, Illinois, Indiana, Kentucky, Massachusetts, Maryland, Michigan, Missouri, Nevada, Ohio, Oregon, Texas, Utah, Washington, Wisconsin.
Essential Duties and Responsibilities include but not limited to
- Review claims for benefit determination based on exception reports of electronic claim submission or hard copy submissions.
- Make corrections when necessary to incorrect participant or provider data.
- Assist Client Services Representatives with difficult claim adjustments/corrections.
- Analyst must be able to determine benefits for multiple groups and process claims accurately according to the corresponding Plan Documents.
- Primary responsibilities will not include telephone or personal interaction with participants or providers unless; it is determined by a supervisor or manager that assistance is needed in this area.
- Regular and predictable attendance is an essential function of this job.
Qualifications - Individual must have previous medical claims processing experience and knowledgeable of medical terminology (i.e., CPT codes, ICD-9 codes, HCPCS, ADA codes). Analyst must be methodical and possess the skills to determine approval for benefit payment, versus pending or denying. Analyst will be accountable for benefit determinations. Excellent customer service skills are a must.
Applicants for this remote role will only be considered if they live in these locations: Arizona, California, Colorado, Washington DC, Iowa, Illinois, Indiana, Kentucky, Massachusetts, Maryland, Michigan, Missouri, Nevada, Ohio, Oregon, Texas, Utah, Washington, Wisconsin.
Education and/or Experience - High School diploma or GED equivalent and two years related experience.
Language Skills - Ability to read and interpret documents such as Summary Plan Descriptions of Plan rules. Ability to communicate professionally and clearly with other departments of BeneSys.
Mathematical Skills - Ability to apply concepts of basic addition, subtraction, multiplication and division.
Reasoning Ability - Ability to apply common sense to carry out detailed written or oral instructions.
Certificates, Licenses, Registrations - None required.
Work Schedule
Part Time, working 26-29 hours.
Monday – Friday, starting no earlier than 6am EST. Must be a set schedule each week.
Remote position (No in-office days).
Part Time, working 26-29 hours.
Monday – Friday, starting no earlier than 6am EST. Must be a set schedule each week.
Remote position (No in-office days).
Competitive Benefits and Compensation Package
- Paid Time Off (PTO) - Pro-rated based on work schedule
- Holiday Pay – Pro-rated based on work schedule
- 401k with employer match
- Career development opportunities
- Referral bonus for all successful full-time referrals
Pay
Hourly rate for this position is $22.00. Actual rate dependent on location, skills, education, experience and other business factors.
Our Culture
BeneSys wants to be a great service provider to the members we serve, and we recognize we can only do that if we are also a great employer with successful employees. In short, our success is driven by our employees’ successes. We want to be a place where people want to work, feel proud of what they do and feel fulfilled both professionally and personally. We want to create a place where employees can find long-term growth and potential.
Our culture focuses on three core values:
- Collaboration: working together across 31 locations to achieve the best for the company and our clients
- Dedication: striving to create an environment where all employees work toward a common goal while committing to providing the best customer service to our members and our colleagues
- Integrity: doing what we say we will do. Upholding strong ethical and moral principles
ADA & EEO
Reasonable accommodations will be made so that qualified individuals with disabilities are able to complete the application process and, if hired, fulfill the essential functions of their job.
