Assistant Claims Examiner (Hybrid) - $14

Hybrid 1-2x a week in Irving, TX

Targeting $14/hr

Looking for paralegal or Medicaid/Medicare experience

Candidates must have strong attention to detail, ability to read fine print, research and make educated decisions. Strong computer skills, ability to switch between different programs (Microsoft tools, web browsing)

Summary:

• Processes less complex or small standard claims to ensure accurate and timely completion.

Essential Job Functions

• Enters insurance claims received electronically or in written form.
• Answers incoming customer calls regarding claim processing.
• Documents claim and associated history.
• Evaluates available information to validate straightforward basic claims.
• Verifies policyholder information, policy effective dates, premium status and verification of claim eligibility.
• Sends claim form to claimant for updating, correction or completion.
• Identifies need for additional information; contacts appropriate source to obtain needed information.
• Verifies beneficiary or claimant information if claim is warranted. Identifies payment amount and obtains required management approvals for payment. Processes payment.
• Advises claimant of status and resolution of claim.
• Escalates claimant concerns as appropriate.

Basic Qualifications

• High school diploma or G.E.D.
• 1+ year of Claims Experience
• Experience working with insurance and/or medical terminology -Experience working with appropriate claims processing procedures and documentation

Other Qualifications

• Communication skills to communicate with customers
• Data entry skills
• Ability to keep sensitive and confidential material private
• Ability to work in a team environment
• Work Environment
• Office environment