Job Details
Review, research, solve and process assigned work. This would include navigating multiple computer systems and platforms (e.g. verify pricing, prior authorizations, applicable benefits) Ensure that the proper benefits are applied to each claim by using the appropriate tools, processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/ Medicare guidelines, benefit plan documents/ certificates tool) Independently complete daily all documentation and communicate the status of claims as needed adhering to all reporting requirements Learn and leverage new systems and training resources to help apply claims processes/procedures appropriately (e.g. on-line training classes, coaches/mentors) Meet and maintain the performance goals established for the position in the areas of quality, production and attendance Consistent attendance with ability to meet work schedule including the required training period Successful completion of the United...Claims Representative, Associate, Claims, Representative, Remote, Benefits, Insurance, Healthcare