Claims Processor Associate

Company Name:
The Claims Associate identifies necessary steps and processes claims of varying complexity levels,dependent on skill level. Using complex systems- Research, analyze, and price claims in accordance with processing guidelines as well as Provider and Customer contracts.
-Researches and computes provider contracts using basic math skills and multiple programs for claim allowed amounts.
-Locates and interprets complex information from a number of databases in order to process claims.
-Completes tasks quickly with the ability to understand complex written directions,instructions, and technical information.
-Performs follow-up actions necessary to ensure customer satisfaction.
-Ability to take personal ownership for meeting/exceeding all Key Performance Indicators as well as quality standards
- Understands and utilizes all Management Operating System tools to include Daily Production Log,Performance Profile, and various claim systems.
-Maintains established schedule adherence and compliance standards.
-Demonstrates ability to:
Take information frommany sources, follow guidelines and make educated decisions quickly
Use multiple windows based applications simultaneously
Use of keyboard shortcuts or hot key processes
Function in a team based/matrix environment
Learn new skills rapidly - self motivated and career driven
Comfortable with ambiguity and change
Strong commitment, drive and motivation to provide excellent customer service
Commitment to work - adheres to schedules
Abilityto communicate clearly, professionally and empathetically- both verbal and written
Appropriate sense of urgency and strong attention to detail
Experience working in independently or in a virtual environment a plus
Ability to organize and prioritize work, meeting quality standards and Key Performance Indicators while managing changing priorities
HighSchool diploma or equivalent is required
College education or related work experience preferred
Previous claim processing experience is a plus but not required
Work experience inthe Service Industry preferred
Competencies Needed for Success
Problem Solving
Learning and Applying Quickly
Customer Focus
Job: Bus Ops--Claims
Title: Claims Processor Associate
Location: Illinois-Bourbonnais
Requisition ID: 14002011

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