Insurance Claims Processor
WVU Medicine
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteJob Level
Junior
About the role
- Determines accuracy and completions of claim information
- Entry/verifies claims data
- Resolves claim edits, review history records, and determines benefit eligibility for service
- Reviews payment levels to arrive at final payment determination
- Meets all production and quality standards, maintaining workques according to department standards
- Effectively communicates with internal and external staff
- Elevates issues to next level of supervision, as appropriate
- Ensures accuracy of data entered and record maintenance
- Attends all required training classes, demonstrating proficiency and ability to learn
Requirements
- High School diploma/GED
- One (1) year of experience working with medical or institutional claim data entry OR customer service experience
- Associate Degree in related healthcare field (preferred)
- Two plus years of medical or institutional claims processing and customer service experience (preferred)
- Working Knowledge of administrative and clerical procedures and systems such as word processing and managing files and records
- Ability to take direction and to navigate through multiple systems simultaneously
- Excellent written and oral communication, customer service, interpersonal skills, and telephone etiquette
- Ability to solve problems with predefined methods and guidelines to drive improved efficiencies and customer satisfaction
- Basic knowledge of covered services
- Knowledge and understanding of medical terminology, third party payors and insurance preferred
Benefits
- Standard office environment with electrical equipment (i.e., telephone, personal computer, copier, fax machines, etc.)
- Health insurance
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims data entryclaims processingdata accuracyrecord maintenancemedical terminologythird party payorsinsurance knowledgeadministrative proceduresclerical proceduresproblem-solving
Soft skills
communicationcustomer serviceinterpersonal skillstelephone etiquetteability to take directionability to navigate systemsefficiency improvementattention to detailteam collaborationadaptability
Certifications
High School diplomaGEDAssociate Degree in healthcare field