Claims Processor

Posted: 8/30/2019 7:07:42 PM

Job Snapshot

Location: Madison, WI, US
Posting ID: 6918136

Job Summary



Job Description:

Claims Specialists are responsible for providing accurate and timely claims processing of complex claims in order to provide excellent service to members and providers. The Claims Specialist will have advanced knowledge of the variety of products, medical terminology, and various benefit options which impact claims processing. The Claims Specialist reviews claims for accuracy and completion and to obtain missing information as necessary. The incumbent will determine claims coverage by examining company records, confirm claims payment amounts, and submits claims for payment in a timely manner consistent with expected turnaround times.

Essential Job Duties:

1. Process complex claims in accordance with the claims processing system and other department guidelines.
2. Research problem claims accounts; reverse and reprocess claims as necessary.
3. Review provider status to determine participating/nonparticipating, primary, referral and correct reimbursement level, which may include re-pricing.
4. Process written inquiries from providers regarding benefits and claims and escalate as appropriate.
5. Process provider appeals of claim determination to resolve or escalate as appropriate.



Hours:
  • Hours-8:00am-5:00pm- Mon-Fri


Pay:
  • $18-26/hour- based on experience


Location:
  • West side of Madison


If interested please call me at 608 - 240- 3121 or Email me at Wheckendorf @Aerotek.com







About Aerotek:

We know that a company's success starts with its employees. We also know that an individual's success starts with the right career opportunity. As a Best of Staffing® Client and Talent leader, Aerotek's people-focused approach yields competitive advantage for our clients and rewarding careers for our contract employees. Since 1983, Aerotek has grown to become a leader in recruiting and staffing services. With more than 250 non-franchised offices, Aerotek's 8,000 internal employees serve more than 300,000 contract employees and 18,000 clients every year. Aerotek is an Allegis Group company, the global leader in talent solutions. Learn more at Aerotek.com.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888-237-6835 or email accommodation@aerotek .com for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.

Skills

claims
appeals

About CareerCircle

The statistic has gone viral that there will be a talent shortage of 85.2M people by 2030. CareerCircle was founded in the spirit of finding solutions to address the pending skills gap versus falling victim to it. With so many capable people wanting to find employment and employers needing partners to achieve their goals, CareerCircle is here to provide a bridge.

At CareerCircle, we recognize that CareerskillingTM is the fastest path to improved performance and securing your ideal role. To advance your skills, you need access to the highest caliber of online education technology that is delivered in a meaningful way. Here is where we come in. We partner with experts in education technology to deliver unique learning experiences that can be instructor-led or self- paced, supplemented with the necessary support for optimal results. By completing the coursework provided by these groups, candidates gain the ability to be marketed to recruiters and potential employers with an emphasis on acquired skills and performance, versus limited work history or listed resume experience. In the end, your journey of advanced education leads to higher pay, flexibility, and a better life.

Contact Information

Name: Wade Heckendorf
Phone: (608) 240-3121