Spectrumhealth · Fort Wayne, INPrepare for this interview
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Job Summary The Coord must be competent in all functions of a Claim Coord, Assoc and Coord, Claims in addition to more complex claim and issue resolution. Examples of complex claims may include: secondary claim coordination; customer inquiries; claims adjustments. This position is production and quality based and the Coord will be expected to achieve monthly measures. Essential Functions Process claims through on-line adjudication. May include HMO, ASO, PPO, LFO POS, or GP. Processing will include complex claims such as secondary claim coordination, customer inquiries, claim adjustments and complex issue resolution. Utilize Lens Inquiry Tracking system to initiate and resolve claim related issues. Detailed knowledge of operational/technical functions and software. Ability to perform tasks in a high stress environment. Ability to complete multiple tasks in a timely manner. Ability to meet minimum production and quality standards Ongoing oral and written communication within teams. Assist in special projects as assigned.
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