Claims Payment Processor Jobs in Union, Arkansas

Minimum of 1 year experience in handling loan or payment processing

Experience with various types of principal and interest calculations

Responsible for processing and recording payment accurately, timely and efficiently in Ventures

Board new loans and post disbursements in Ventures

Sets up ACH for newly funded loans

Processes loan payments (ACH NACHA import and manual entry of checks)

1-3 years of relevant work experience including claims submission/processing experience

Excellent verbal and written communication skills

Problem-solving skills to analyze, troubleshoot and resolve issues

Structured thinker and love checking things off your to-do list

An innovative spirit to push the boundaries

Ability to thrive in a fast-paced, results-oriented environment

Review, process, and resolve moderately complex claims in accordance with contracts and policies.

Research claims through the utilization of reference materials and on-line tools.

Responsible for accurately coding claims through the system.

Translate data into information acceptable to the claims processing system including follow up on pended claims.

Maintain all appropriate claims files and perform follow-up on pended claims.

Prepare claims for return to Provider or Subscriber when additional information is needed.

Professional and effective written and verbal communication skills.

Good analytical, problem solving, decision making and detail-oriented skills with ability to shift priorities as needed.

Good organizational abilities and the ability to handle a variety of functions .

Knowledge and understanding of Moda Health administrative policies affecting claims and customer service.

Responds and follows up using FACETS, Content Manager and E-mail.

Medical, Dental, Vision, Pharmacy, Life, & Disability

• COB and benefit summary knowledge

• Pay or deny claims according to the benefit summary

• Priority will be given to those with knowledge of the QNXT systems and application

• Knowledge of Medicaid, Medicare or commercial claims processing

• Experience with claims or customer service in medical field

Years of Experience: 2.00 Years of Experience

• COB and benefit summary knowledge

• Pay or deny claims according to the benefit summary

• Priority will be given to those with knowledge of the QNXT systems and application

• Knowledge of Medicaid, Medicare or commercial claims processing

• Experience with claims or customer service in medical field

• Review membership eligibility for determination

6-12 months data entry or medical office experience preferred

Knowledge of medical terminology, CPT codes and ICD-9/10 codes preferred

Professional and effective written and verbal communication skills

Experience with Facets platform a plus

Identify all the duties and responsibilities

Medical, Dental, Vision, Pharmacy, Life, & Disability

6-12 months data entry or medical office experience preferred

Knowledge of medical terminology, CPT codes and ICD-9/10 codes preferred

Professional and effective written and verbal communication skills

Experience with Facets platform a plus

Identify all the duties and responsibilities

Medical, Dental, Pharmacy and vision coverage

Provide accurate and prompt information to management, employees, and clients.

Assist management by sending letters, making copies and making reservations, when requested.

Building and expanding on skills by engaging in educational opportunities.

Willingness to continue building skills through educational opportunities.

Minimum of 2 years’ experience in a related field

Strong problem solving, critical thinking, interpersonal, verbal & written communication skills.

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Logs and edits claims via the claims system, and researches submitted claims if applicable.

Handles more complex requests for claims processing; escalates where needed.

Contacts appropriate parties to request missing information from requests or for additional information as requested.

Participates in interdepartmental collaboration to enhance the claims processing function.

Meets department quality and production standards.

ICD-9 and CPT coding and general practices of claims processing. Prefer knowledge of capitated managed care environment.

Major Functions (Duties and Responsibilities)

Major Functions (Duties and Responsibilities) Cont

Two (2) years experience in examining and processing medical claims; professional or institutional.

Medicare/Medi-Cal experience preferred. Claim adjustments, provider appeals and/or disputes preferred.

Microcomputer skills, proficiency in Windows applications preferred. Excellent communication and interpersonal skills, strong organizational skills.

2 years of experience processing, researching, and adjudicating claims

Strong organizational, analytical and judgment skills

Strong oral and written communication skills

5 years-of experience processing and adjudicating claims

CES, CORDS, OR AMMS experience

Knowledge of mathematical and statistical concepts

Minimum of 1-year mortgage servicing experience; specifically, in the procurement and payment of property taxes

1+ years clerical and/or office experience

Excellent mathematical and analytical skills

Knowledge of Real Estate Settlement Procedures Act (RESPA) and Consumer Financial Protection Bureau (CFPB) regulations

Performs basic clerical duties such as copying, scanning and filing of property tax and other documentation

Initiates and submits check requests for agency fees and penalties

2 years of experience processing, researching, and adjudicating claims

Strong organizational, analytical and judgment skills

Strong oral and written communication skills

5 years-of experience processing and adjudicating claims

Knowledge of mathematical and statistical concepts

We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities.

Upholds Kaiser Permanente's Policies and Procedures, Principles of Responsibilities, and applicable state, federal and local laws.

One (1) year relevant experience in health care industry.

Preferred experience with processing disability claims with EDD and release of Information processing.

This is a hybrid on-site/remote position processing Disability claims with EDD and fulfilling requests for Release of Information

Screens disability claims, interviews patients, locates and orders medical records.

Abstracts medical information and diagnoses using ICD-9 codes.

ACH background & Reg E Experience (In depth Reg E principal knowledge)

2+ years of Banking or financial experience (ideally experience managing claims in high pace environment)

Experience in a high volume environment dealing with claims and meeting defined metrics

Review any claims that are flagged and need to be reviewed or any claims that were not automated

Work with leads in the case issues come up that need to be approved

Stability/ longevity in previous roles

2 years of experience processing, researching, and adjudicating claims

Strong organizational, analytical and judgment skills

Strong oral and written communication skills

5 years-of experience processing and adjudicating claims

Knowledge of mathematical and statistical concepts

Examine and process complex or specialty claims according to business/contract regulations, internal standards and examining guidelines

Manages incoming manual claims from multiple clients to our secure server

Other responsibilities or projects as assigned

3-5 years of healthcare experience

Excellent verbal and written communication skills

Strong internal and external communication skills, both verbal and written

Must be able to operate computers and phones to support position requirements