Claims Assesor (URGENT)

Essential Functions:

Acknowledge receipt of Claim requests.Upload claim documents to case in the health claims systemValidate claim details in the health claims systemUpdate Claim status and notes in the health claims systemUpdate TPA file for endorsement to Claims Control TeamAdheres to service standards of processing administrative requestsEnsures complete claim file documentation and submissionSends out letters requesting information for claims filesMakes follow up telephone calls such as requesting medical information from physicians,scheduling of Health Screening with provider, provider’s payments and outstanding bills.Ensures complete and accurate claim file documentationMaintains an understanding of the different client relationships and productsAssist with mail sorting and distributionAttends to other duties and responsibilities needed.

Education and Experience:

College graduate of any 4-year medical coursePreferably with health claims processing background

Knowledge, skills and Abilities

Ability to initiate and prioritize regular work duties and small projects, ability to multitask,be detail oriented, organized and possess good time management skillsAbility to work independently and as part of a teamGood computer skills with basic skills in Excel, word and outlookAbility to use office equipment including photocopier and printerGood knowledge on medical claims processingAccurate data entry skills with a keyboarding speed of 40-45 wpm