Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.
Client is responsible for all Claims Operation and Management functions of Medical Assistance Services. The primary role of a Claims Resolution Specialist is to provide exceptional customer support for incoming and outgoing Provider Claims processing.
Your role in our mission
Help create the power in our processes as we develop purpose-built technologies and solutions that yield better health and human services outcomes.
- Review and research claims based on claims processing guidelines.
- Refer claims to the appropriate department.
- Prepare Return to Provider (RTP) forms as necessary when required claim information is missing or invalid.
- Self-motivated with good time management and organization skills.
- Ability to work with several different teams, tasks, and completing deadlines to ensure all work is completed accurately.
What we’re looking for
- Knowledge of the fundamental concepts and principles in the medical and/or insurance fields
- Basic reading and analysis skills to evaluate claims and make adjudication decisions
- Basic computer use skills
- Ability to multi-task across multiple claims to work efficiently
- Ability to work independently to meet individual production goals
What you should expect in this role
- Strong analytical and problem-solving skills
- Strong communication skills to communicate with clients.
- Ability to keep sensitive and confidential material private.
- Candidate must be able to come into the office for 2 weeks of training.
- The starting hours would be 8 am to 5 pm, Monday through Friday.
- REMOTE