Claims Production Professional - Fully Remote in WA, OR, ID & UT
Full Time
Boise, ID
Posted
Job description
Remote within ID, OR, WA, or UT. Candidates outside of these states will not be considered.
Claims Production Professional starting pay range $15.00 - $18.00 DOE and Location. HR will reach out and provide specific information.
Position starts: Monday, October 17th, 2022
Primary Job Purpose
Provide basic data entry, claims processing and coordination of benefits by investigating and applying contract benefits to submitted claims while meeting department standards for quantity, accuracy, timeliness, and dependability. Provides responsive customer service to members, providers and other business partners.
General Functions and Outcomes
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Adapt to daily changes in workload/responsibilities based upon department/division goals and priorities
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Adapt to regular system, procedural and contract changes as they affect your daily processing
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Analyze and investigate claims for processing in a timely and accurate manner
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Apply benefits to claims by following all necessary warning messages and edits to ensure accurate claim completion
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Consistently adhere to all department established performance expectations for quality and production
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Follow all established department rules for behavior, attendance, appearance, and timekeeping
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Identify and report any irregularities or problems in claims processing to the appropriate area
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Maintain access to and utilize all references, documents, policies, and procedures to ensure correct application of contract benefits
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Maintain confidentiality in all aspects of claims processing, including correspondence and contacts
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Provide clear audit trails on claims processed so others can easily complete work in case of absence
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Provide excellent customer service to customers, providers, members, and member representatives
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Review and reprocess previously adjudicated claims
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Successfully complete basic claims training and any departmental audit process
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Other duties as assigned
Minimum Requirements
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Computer experience needed including working knowledge of Microsoft Office software, such as MS Word, Outlook, and Excel, or other comparable programs
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Basic math skills
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Keyboarding skills
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Strong attention to detail
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Excellent interpersonal skills
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Communicate effectively orally and in writing
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Work independently as well as a member of a team
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Ability to work under pressure and meet deadlines
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Meet dependability, timeliness, attendance, quantity, and quality standards as established by department
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Provide excellent customer service when communicating with external and internal customers
Normally to be proficient in the competencies listed above:
Claims Production Professional I would have a high school diploma or equivalent and 1 year office experience, preferably in health insurance claims or in a medical office setting, or equivalent combination of education and experience.
Work Environment
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Repetitive keying movements
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Sitting for extended periods of time processing and investigating claims
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Travel to other locations, as job requires
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May be required to work overtime.
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May be required to work outside normal hours.
This position includes 401(k), healthcare, paid time off, paid holidays, and more. For more information, please visit
www.cambiahealth.com/careers/total-rewards
.
We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.
If you need accommodation for any part of the application process because of a medical condition or disability, please email
CambiaCareers@cambiahealth.com
. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our
Privacy Policy
. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our
Careers
site.
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