Westaff is seeking Claims Examiners for their client in Schenectady!
This is a great contract opportunity to work with large health insurance company in the Capital District!
Schedule: Monday-Friday 8:00 AM-4:30 PM
Rate of Pay: $14.00/hour
- Adjudicates claims with the aid of the Facets and Macess Systems
- Reviews and ensures the accuracy of all provider, member and claim line information for all claims for which the examiner is responsible
- Reviews and ensures the accuracy of all changes to claim line information based on information received from other departments and in accord with available benefit information
- Responsible for the timely and accurate adjudication of claims that are suspended to other departments for benefit and/or authorization determination
- Meets or exceeds department quality and work management standards for claims adjudication
- Successfully completes a course of comprehensive formal training in all areas of benefits determination, system navigation, and policy
- Suspends, investigates and resolves claim issues by coordinating with appropriate departments, based on criteria set by those departments
- Handles inquiries regarding suspended claims from other departments and identifies trends in suspensions based on these inquiries and other feedback
High school diploma or equivalent
Previous health, dental or vision insurance experience required. Previous claims processing experience preferred.
• Strong communication skills
• Organizational skills and attention to detail;
• Strong PC skills required, Microsoft Windows experience highly desired
Call/Text 518-438-3010 to schedule your interview today!