Claims Analyst analyzes and reviews insurance claims for accuracy, completeness, and eligibility. Reviews claims for eligibility to be reimbursed. Being a Claims Analyst maintains updated records and prepares required documentation. Assists in controlling the cost of processing claims. Additionally, Claims Analyst contacts policyholders about claims and may provide information regarding the amount of benefits. May require a bachelor's degree or its equivalent. Typically reports to a supervisor or manager. The Claims Analyst gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Claims Analyst typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Must live within 50 miles of Ontario, CA!
Description:
Specific Duties:
1. Answer 50-70 Inbound Calls daily
2. Resolve Member/Provider Inquiries
3. Provide Claims disposition
4. Provide Authorization status
5. Master internal department workflow processes
6. Ability to demonstrate Empathy/Compassion
Must have qualifications/experience:
1. Healthcare experience working within a call center environment
2. Claims knowledge
3. Eligibility
4. Risk - payment methodologies FFS vs CAP
5. Ability to attain quality call outcomes - provide 5 star service
6. Bilingual Spanish Vietnamese Farsi Korean Chinese preferred any or all
7. Dependable/Reliable/Punctual
Shift Start/End Time: 8:30 to 5:00 pm Mon-Friday
Dress Code: Casual - Business casual
Work Location: Remote must reside in CA
About TEKsystems:We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
About the Company:
TEKsystems
About TEKsystems:
Company Size:
5,000 to 9,999 employees
Industry:
Staffing/Employment Agencies
Founded:
0
Website:
https://www.teksystems.com/en/
Clear All
0 Claims Analyst jobs found in Anaheim, CA area