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Claims Processor

Claims Processor Location MI: Wixom (48561 Alpha Drive, Suite #150) Job Family C

2020
2019-07-16
Beacon Health Options
Position: Claims Processor Salary: Unspecified Type: Full Time Location: Wixom, MI
Location
MI: Wixom (48561 Alpha Drive, Suite #150)
Job Family
Claims
Job Brief
Beacon Health Options is currently seeking a dynamic Claims Processor to join our team in Wixom, MI! The Claims
Processor will be responsible to process claims promptly and accurately.
About the Position:
Beacon Health Options is currently seeking a dynamic Claims Processor to join our team in Wixom, MI! The Claims
Processor will be responsible to process claims promptly and accurately in accordance with the Department and Company
policies and procedures.
Position Responsibilities:
Verify the accuracy of claims data entered by a data entry clerk and accurately complete the data entry of additional
claims data necessary to adjudicate the claim.
Research claims for additional or missing information.
Utilize pre-established screening guidelines and templates to review claims information to determine member eligibility,
level of benefits and if claims should be paid.
Route claims information to appropriate departments for action, if necessary.
Review open claims’ reports on a daily basis to ensure that claims are processed quickly and accurately while meeting
Departmental accuracy, productivity and performance standards
Process mailbacks and submit for audit.
Complete daily production logs and turn them in daily to the Claims Department Manager by the end of shift or before
leaving for the day.
Ensure that any data required for reporting purposes is entered as instructed by auditor or directed by management.
Promptly raise any issues delaying resolution of the claim to management.
Contribute to overall success of the claims department in meeting performance guarantees to customers and maintaining
customer standards.
Position Requirements:
Education: High school diploma or GED equivalent required
Licensure: Claims/Billing certification from an accredited business institution preferred
Relevant Work Experience: 1 year of claims processingor medical billing experience required
Certification from an accredited business institution related to billing/claim administration and 6 months office/clerical
experience may be substituted
Knowledge, Skills, & Abilities:
Knowledge and experience using management information systems and software
CAS or other computerized claims processing system
Word processing and spreadsheet applications
Ability to utilize pre-established screening guidelines and templates with accuracy
Ability to key with accuracy and pass a test of data entry skills
To Apply:
Click below on "Apply for this Position" to create a profile and apply for the position
Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and
Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled
At Beacon Health Options, our candidate’s data privacy is a top priority. Our recruiting team conducts all communications
using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position
through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts
all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any
financial or personally identifiable information from you.
Apply

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