ScottsdaleRecruiter Since 2001
the smart solution for Scottsdale jobs

Claims Examiner - Hybrid

Company: AGIA
Location: Scottsdale
Posted on: May 16, 2022

Job Description:

The Claims Examiner is responsible for analyzing and adjudicating claims for group cancer and hospital indemnity plans in a timely and accurate manner and in strict accordance with defined carrier, state and federal requirements to ensure an excellent customer experience.Essential Job Functions

  • Research submitted claims and records regarding eligibility and compliance with the provisions of the Certificate of Coverage to ensure accurate application of coverage benefits.
  • Process low to medium complexity claims to ensure timely and accurate response to claimants in strict accordance with carrier, state, federal and internal compliance requirements.
  • Generate concisely written correspondence to members, insureds and providers to request required information in a timely and accurate manner and follow-up as needed.
  • Monitor and review pended claims to ensure that final claim determination and follow-up are performed in accordance with carrier, state and federal requirements.
  • Support the Member Benefits Service Department with customer inquiries.Qualifications
    • High school degree or equivalent.
    • One year claims analysis and adjudication experience with health claims preferred.
    • Knowledge of CPT codes, RVS codes and ICD9/10 coding and medical terminology.
    • Basic proficiency in MS Office.
    • Strong attention to detail.
    • Strong alpha numeric and ten-key typing skills.
    • Ability to work in a fast paced and changing environment.
    • Excellent customer service skills.
    • Good verbal, written and interpersonal skills.
    • Good deductive reasoning, problem solving and analysis skills.Work Environment:
      • No weekend work; Monday-Friday only
      • A relaxed work environment with casual dress everyday
      • Covered parking year around
      • Located by a variety of restaurants, shopping venues and public transportationWhy You Should Apply:
        • AGIA Affinity Services has over 60 years of unparalleled success
        • We offer competitive pay with a 401K company match
        • We offer a competitive and intuitive benefit package, first of month after date of hire
        • Paid vacation
        • 13 Paid Holidays
        • We are a group of individuals who work, volunteer and hang out together
        • We give back to our surrounding communities through various channels
        • Remote, following completion of in-person training

Keywords: AGIA, Scottsdale , Claims Examiner - Hybrid, Other , Scottsdale, Arizona

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Log In or Create An Account

Get the latest Arizona jobs by following @recnetAZ on Twitter!

Scottsdale RSS job feeds