Claims Processor I

Requirements

• Education High School Diploma or equivalent required
• Associate's is preferred
• Work Experience 1 year of related clerical or data entry is required
• A medical office or medical coding diploma can be used in lieu of the one year of experience
• Completion of the Medical Assistant, Coding & Insurance Pathway from BRCC, can be used in lieu of the one year of experience.
• Claims processing or claims coding experience is preferred
• Skills and Abilities Must be able to enter data at 4000 keystrokes per hour
• Medical coding training is preferred
• Must be able to demonstrate critical thinking and problem solving skills
• Familiarity with medical and health insurance terminology preferred
• Demonstrated verbal and written communication skills with the ability to interpret and communicate information with tact, diplomacy, patience and professionalism.
• Must demonstrate PC skills including Microsoft Office (e.g., Word, Excel, Outlook, etc.)
• Licenses and Certifications
• None Required
• Rejects, redirects misrouted or sends back claims when information is incomplete or inaccurate to facilitate timely processing ensuring that claims are processed according to departmental guidelines and assist with customer service.
• Researches procedural questions in training manual.
• Additional Accountabilities and Essential Functions
• Job duties are performed in a normal and clean office environment with normal noise levels.
• Work is predominately done while standing or sitting.
• The ability to comprehend, document, calculate, visualize, and analyze are required.
• An Equal Opportunity Employer
• All internal employees please apply through Workday Careers.
• PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)
• Additional Information
• Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section

Benefits

Additional Information

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with us. Residency in or relocation to Louisiana is preferred for all positions. POSITION PURPOSE Researches and verifies complex claims information to ensure the accurate and timely processing of claims. Enters all information needed to process claim. Identifies inconsistencies and makes necessary corrections. Accountable for complying with all laws and regulations associated with duties and responsibilities. NATURE AND SCOPE This role does not manage people This role reports to this job: SUPERVISOR, CLAIMS OPERATIONS Necessary Contacts: In order to effectively fulfill this position, the Claims Processor I must be in contact with: Various internal departments and staff including, but not limited to, Provider Services, Legal, Internal Audit, IT, other Benefits Operations Management and staff, Membership and Billing, Administrative Services, and District Offices. Various external entities including, but not limited to, Providers, Members, Lawyers, Groups, Commissioner of Insurance, other insurance companies, and other Plans.

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