Claims Examiner - Hybrid
Posted on: May 16, 2022
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
- 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
- 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
- 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
- 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
- We give back to our surrounding communities through various
- Remote, following completion of in-person training
Keywords: AGIA, Scottsdale , Claims Examiner - Hybrid, Other , Scottsdale, Arizona
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