Job title: Claims Processor (Full Remote) PST Time Zone only
Company: Morgan Stephens
Job description: Job Description: Remote Claims ProcessorPosition: Remote Claims Processor
Pay Rate: $20/hr
Schedule:
- Training: 8:30 AM – 5:00 PM PST
- Post-Training: 7:00 AM – 4:00 PM PST
Key Responsibilities: * Meet or exceed claims accuracy standard of 95% or greater.
- Maintain overpayment and underpayment standard of 98% or greater.
- Meet or exceed the department production quota of 30 claims per hour.
- Adjudicate and process PCP claims, applying all claims policies, contracts, practices, and ensuring compliance with industry regulations and guidelines.
- Work independently to resolve claims and make claims resolution decisions with limited supervision.
- Confirm eligibility for claims billed and the date of service.
- Comply with claims timeliness guidelines for PCP providers, ensuring a turnaround time (TAT) of no greater than 90 days.
- Adhere to all company and department policies and procedures.
Day-to-Day Responsibilities: * Resolve claims issues identified through processing errors and recommend improvements to avoid future errors.
- Process and adjudicate claims in the order they are received (First In, First Out).
- Address grievances and complaints received through the Claims Customer Service Call Center.
- Provide prompt and accurate responses to claims-related questions from supervisors and management.
- Identify overpayments or underpayments during reviews or history searches, report them per department protocol, and follow up as needed.
- Be able to sit for lengthy periods, up to three hours at a time.
- Be able to lift a maximum of 10 pounds.
- Perform any additional tasks or assignments as required by the Claims Supervisory Team and Upper Management.
Required Skills: * Knowledge of CPT and ICD-9 codes, and medical terminology.
- High school diploma or equivalent.
- Excellent verbal and written communication skills.
- Strong organizational skills and interpersonal skills.
Required Experience:
- 3-5 years of relevant experience.
Additional Requirements:
- Must work in PST timezone.
Opportunity: This is a temp-to-perm position with the potential to be hired permanently after 13 weeks based on performance. Pay: $20.00 per hourBenefits:
- Various levels of benefit plans available, including health, dental, and vision, offered by the agency at an additional cost.
- Temp-to-perm opportunity after 13 weeks.
Expected salary: $20 per hour
Location: Long Beach, CA
Job date: Mon, 29 Jul 2024 07:53:27 GMT
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