Medical Claims Entry Operator- (Hybrid OR & WA)

Full Time
Portland, OR 97222
Posted
Job description

Let’s do great things, together!

Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.

Enters the processing system all claims received by mail or route claims as directed to processing specific data entry queues. Interrogates data on claims received electronically where member or provider information does not match Moda records.


Benefits
:

  • Medical, Dental, Vision, Pharmacy, Life, & Disability
  • 401K- Matching
  • FSA
  • Employee Assistant Program
  • PTO and Company Paid Holidays
Schedule:
  • PST

Required Skills, Experience & Education:

  • High school diploma or equivalent.
  • Six months data entry experience.
  • 10-key proficiency of 135 spm net on a computer numeric keypad.
  • Typing ability of 35 wpm net.
  • Proficiency with Microsoft Office applications and an understanding of basic claims processing rules.
  • Strong problem solving and detail orientation skills.
  • Medical terminology helpful.
  • Ability to adapt to frequent changes in instructions.
  • Ability to come into work on time and on a daily basis.
  • Maintain confidentiality and project a professional business image.
Primary Functions :
  • Data enters claims accurately using Moda computer systems. Reassigns claims appropriately as outlined by Medical Claims processing guidelines.
  • Resolves claims that pend with errors in the processing system by matching claims received to Moda providers or member records.
  • Research and problem solve basic claims data.
  • Identifies and communicates trends.
  • Performs other duties as assigned.

Together, we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.

For more information regarding accommodations please direct your questions to Kristy Nehler and Daniel McGinnis via our humanresources@modahealth.com email.

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