Claims Processor

-Analyzes and adjudicates routine claims, determining approval on file, eligibility, identify discrepancies, and applies all cost containment measures to assist in the claim adjudication process.

-Responds to routine phone inquiries and written correspondence related to claim processing issues and/or needs.

-Screens and routes complex claims to claim manager.

-Proofs claim, review and apply appropriate guideline, coding, member identification, and processes in appropriate turn-around-time.

-Facilitates training in accordance with operational guidelines and manages claims assignment

-Navigates multiple systems to obtain necessary data to adjudicate claims appropriately.

-Ensure payments and/or denials are made in accordance with company practices and procedures.

-Collaborates with customer service team requesting and/or providing feedback and follow up to assist in treatment as well as claims authorization.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.

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-High school diploma/GED required

-2+ years of experience as a medical claims processor in a health insurance or related field company

-Strong analytical, detail-oriented and accuracy skills are required

-Ability to manage time effectively, set priorities, meet deadlines as well as adapt to change

-Desire to work in a small entrepreneurial environment

-Healthcare related insurance experience is a significant plus

Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.