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Vendor Claims Examiner
Health Plans, Inc.Vendor Claims Examiner at HPI processing vendor claims in accordance with plan benefits. Assisting vendors and clients with questions regarding claims and policies while maintaining quality and production levels.
About the role
Key responsibilities & impact- Process vendor claims in accordance with plan benefits.
- Maintain minimum quality and production levels as determined by the Claims Supervisor.
- Maintain reconciliations as required by the vendor.
- Assist the Vendor Management team with status or claim review.
- Handle correspondence in a timely and efficient manner.
- Resolve claim issues that do not require outside involvement.
- Perform other various tasks that are deemed necessary and equitable by the Claims Supervisor
Requirements
What you’ll need- High School diploma or equivalent education
- Prior claims processing experience, preferably in the healthcare industry
- Ability to coordinate with management as effectively as with subordinates
- Ability to prioritize and multi-task effectively
- Communicates effectively, both verbally and in writing
- Ability to work both independently and as a member of the team
- Ability to anticipate and understand systems interactions
- Must be detailed, analytical and accurate
- Recognize the need for follow-thru and follow-up
- Ability to work within specified timeframe and meet deadlines
- Recognize and maintain confidentiality of work materials as appropriate
- Experience with medical terminology and/or billing and coding is a plus!
Benefits
Comp & perks- Medical, Dental and Vision and Prescription Drug Coverage
- Fitness Reimbursement Benefit
- Employee Assistance Program
- Flexible Spending Account & Health Savings Account
- 401(k) and Quarterly Bonuses
- Generous Paid-Time Off & Volunteering Opportunities
- Educational Assistance & Professional Development Opportunities
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims processingmedical terminologybillingcoding
Soft Skills
communicationprioritizationmulti-taskingindependenceteamworkanalytical skillsattention to detailfollow-throughconfidentiality
Certifications
High School diploma