Claims Processing Clerk, Sr. jobs in Alexandria, LA
Claims Processing Clerk, Sr. receives and inputs new healthcare claims, processes payments, conducts billing research, and responds to telephone inquires. Evaluates claims and administers payment, denies, or returns claims according to policy provisions and organizational guidelines. Being a Claims Processing Clerk, Sr. produces routine and ad hoc reports. Requires a high school diploma. Additionally, Claims Processing Clerk, Sr. typically reports to a supervisor. The Claims Processing Clerk, Sr. works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Claims Processing Clerk, Sr. typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)
Recently Added Claims Processing Clerk, Sr. jobs
Sr. Account Claims Representative
- PMA Companies
-
Alexandria, LA
FULL_TIME
-
As a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions, and company guidelines.
Responsibilities- Promptly investigate all assigned claims with minimal supervision, including those of a more complex nature
- Determine coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable)
- Alert Supervisor and Special Investigations Unit to potentially suspect claims
- Ensure timely denial or payment of benefits in accordance with jurisdictional requirements
- Establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure
- Negotiate claims settlements with client approval
- Establish and implement appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition
- Work collaboratively with PMA nurse professionals to develop and execute return to work strategies
- Select and manage service vendors to achieve appropriate balance between allocated expense and loss outcome
- Maintain a working knowledge of jurisdictional requirements and applicable case law for each state serviced
- Demonstrate technical proficiency through timely, consistent execution of best claim practices
- Communicate effectively, verbally and in writing with internal and external parties on a wide variety of claims and account issues
- Provide a high degree of customer service to clients, including face to face interactions during claims reviews, stewardship meetings and similar account-specific sessions
- Authorize treatment based on the practiced protocols established by statute or the PMA Managed Care department
- Assist PMA clients by suggesting panel provider information in accordance with applicable state statutes.
- Demonstrate commitment to Company’s Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.
- Bachelor's degree, or four or more years of equivalent work experience required in an insurance related industry required
- At least 5 years' experience handling lost time workers compensation claims required; past experience with AL jurisdiction and appropriate licensure is required
- Associate in Claims (AIC) Designation or similar professional designation desired.
- Active license required or ability to obtain license within 90 days of employment in mandated states.
- Familiarity with medical terminology and/or Workers' Compensation
- Strong organizational skills with demonstrated ability to work independently and deal effectively with multiple tasks simultaneously
- Proven critical thinking skills that demonstrate analysis/judgment and sound decision making with focus on attention to details
- Strong verbal, written communication skills and customer service skills
- Computer literacy, including working knowledge of MS Office Product Suite, i.e. Word, Excel, PowerPoint.
- Ability to travel for business purposes, approximately less than 10%.
- 28 Days Ago
Postal Processing Clerk
- Postal Source
-
Natchez, MS
FULL_TIME
- POSTAL CLERKNo Experience Required – Paid Training Provided – Job SecurityThe Postal Service is the largest government related agency in terms of employees. The Postal Service currently employs nearly...
- 13 Days Ago
Mail Processing Clerk - No Experienced Required
- Postal Source
-
Natchez, MS
FULL_TIME
- POSTAL CLERKNo Experience Required – Paid Training Provided – Job SecurityThe Postal Service is the largest government related agency in terms of employees. The Postal Service currently employs nearly...
- 14 Days Ago
Field Claims Adjuster
- EAC Claims Solutions LLC
-
Alexandria, LA
CONTRACTOR
- At EAC Claims Solutions, we are dedicated to resolving claims with integrity and efficiency. Join us in delivering exceptional service while upholding the highest standards of professionalism and comp...
- 2 Days Ago
Field Roof Inspector - Alexandria, LA
- Hancock Claims Consultants
-
Alexandria, LA
CONTRACTOR
- Hancock Claims Consultants specialize in Ladder Assist and Property Inspection Services, collaborating directly with numerous insurance agencies for efficient claims management.At Hancock, we are at t...
- 20 Days Ago
Field Roof Inspector - Alexandria, LA
- Hancock Claims Consultants Technicians
-
Alexandria, LA
CONTRACTOR
- Hancock Claims Consultants specialize in Ladder Assist and Property Inspection Services, collaborating directly with numerous insurance agencies for efficient claims management.At Hancock, we are at t...
- 2 Months Ago
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0 Claims Processing Clerk, Sr. jobs found in Alexandria, LA area
Registered Nurse-Acute Medsurgical A-Full Time
- Christus Health
-
Alexandria, LA
- Description Summary: The 5 North RN has the responsibility and accountability for assessing patient/family health proble...
- 12/12/2024 12:00:00 AM
Registered Nurse-Icu Medsurgical A-Full Time
- Christus Health
-
Alexandria, LA
- Description Summary: The Intensive Care Unit Registered Nurse has the responsibility and accountability for planning, di...
- 12/12/2024 12:00:00 AM
Ultrasound Technologist-Imaging Ultrasound-Full Time
- Christus Health
-
Alexandria, LA
- Description Summary: This Job will apply medical ultrasound to the patient in accordance with a doctor's order and works...
- 12/12/2024 12:00:00 AM
Nuclear Medicine Technologist-Imaging Nuclear Med-Full Time
- Christus Health
-
Alexandria, LA
- Description Summary: Nuclear Medicine Technologist is responsible for coordinating and performing diagnostic medical ima...
- 12/12/2024 12:00:00 AM
Armed Security Officer - ST Frances Cabrini
- Christus Health
-
Alexandria, LA
- Description Summary: Uniformed position at all times. Armed Security Officer’s duties include being a visible deterrent ...
- 12/12/2024 12:00:00 AM
Licensed Practical Nurse-Acute Medsurgical A-Full Time
- Christus Health
-
Alexandria, LA
- Description Summary: Performs the function of a Licensed Practical Nurse, under the direct supervision of a registered n...
- 12/12/2024 12:00:00 AM
Registered Nurse-Icu Neonatal-Full Time
- Christus Health
-
Alexandria, LA
- Description Summary: The competent Nurse, in the same or similar clinical setting, practices independently and demonstra...
- 12/12/2024 12:00:00 AM
Registered Nurse Telemetry
- TotalMed
-
Alexandria, LA
- We are seeking a Registered Nurse-Telemetry for a travel assignment in Alexandria Louisiana.
- 12/12/2024 12:00:00 AM
About Alexandria, Louisiana
Alexandria is the ninth-largest city in the state of Louisiana and is the parish seat of Rapides Parish, Louisiana, United States. It lies on the south bank of the Red River in almost the exact geographic center of the state. It is the principal city of the Alexandria metropolitan area (population 153,922) which encompasses all of Rapides and Grant parishes. Its neighboring city is Pineville. In 2010, the population was 47,723, an increase of 3 percent from the 2000 census....
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Processing Clerk, Sr. jobs
$42,928 to $52,946
Alexandria, Louisiana area prices
were up 1.2% from a year ago
were up 1.2% from a year ago
What does a Claims Processing Clerk, Sr. do?
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Claims Processing Clerk, Sr. in Chattanooga, TN
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Claims Processing Clerk, Sr. in Asheville, NC
When you’re in the beginning stages of writing your insurance claims processing clerk job description, you’ll need to review common qualifications for this job.
January 12, 2020