Claims Examiner I

Employer: American Specialty Health

Description

American Specialty Health Incorporated is seeking a focused Claims Examiner to work in a production environment. This position is responsible for the accurate review, input and adjudication of claims in accordance with regulations, ASH standards and contractual obligations of the organization. Claims is an integral department of American Specialty Health’s offerings to empower people to live longer and healthier lives. We’re responsible for tracking the receipt of claims, adjudication and payment of claims. Due to the nature of the business and always evolving rules and guidelines, Claims is a fun and fast-paced team that enjoys working side by side, developing new ideas for efficiency, and prioritizes a strong focus on exceeding regulatory and contractual standards. Our driving mission is to offer world-class customer service (and expedited reimbursement) to healthcare providers on behalf of our members. Claims offers a career path progression that begins upon hire and allows development-focused staff to achieve two promotions in just one year. We succeed as a team and we prioritize professional development, considering ourselves an operational springboard to spring talented and driven employees toward their future goals.

Remote Worker Considerations:

Candidates who are selected for this position will be trained remotely and must be able to work from home in a designated work area with company-provided technology equipment.

Responsibilities

  • Processes claims accurately and efficiently.
  • Reviews all incoming claims to verify necessary information.
  • Determines that correct member and provider records are chosen and utilized to process claims.
  • Enters claims data and information into the computerized Claims Processing System.
  • Maintains all required documentation of claims processed and claims on hand.
  • Adjudicates claims in accordance with departmental policies, procedures, state and accreditation standards and other applicable rules.
  • Maintains production standards; for direct data entry claims this includes processing an average of 31 claims per hour, with an accuracy rate of 98.5% over each pay period.
  • Verifies data of scanned paper claims at stated standards.
  • Provides backup for other examiners within the department.
  • Promotes a spirit of cooperation and understanding among all personnel.
  • Attends organizational meetings as required.
  • Adheres to organizational policies and procedures.
  • Maintains confidentiality of all claim files, claims reports, and claims related issues.

Qualifications

  • High school diploma required.
  • 6 months data entry experience with 10 key and word processing; minimum 10,000 keystrokes per hour required.
  • Experience processing medical claims and knowledge of medical billing terminology and coding strongly preferred.
  • Proficient in MS Office.

Core Competencies

  • Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
  • Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
  • Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
  • Ability to effectively organize, prioritize, multi-task and manage time.
  • Ability to work and maintain production in a work-from-home (WFH) environment
  • Demonstrated ability to show self-discipline to meet production goals.
  • Demonstrated accuracy and productivity in a changing environment.
  • Demonstrated ability to analyze information, problems, issues, situations, and procedures to develop effective solutions, and to utilize constructive criticism to improve.
  • Ability to exercise strict confidentiality in all matters.

Mobility

Primarily sedentary, able to sit for long periods of time.

Physical Requirements

Ability to speak, see and hear other personnel and/or objects. Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard. Ability to lift up to 10 lbs.

Environmental Conditions

Work-from-home (WFH) office setting

This job posting is not applicable in CO.

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Data Entry Professional

Employer: Amplify Education

A pioneer in K–12 education since 2000, Amplify is leading the way in next-generation curriculum and assessment. Our captivating core and supplemental programs in ELA, math, and science engage all students in rigorous learning and inspire them to think deeply, creatively, and for themselves. Our formative assessment products turn data into practical instructional support to help students at every skill level build a strong foundation in early reading and math. Our programs provide teachers with powerful tools that help them understand and respond to the needs of all their students. Today, Amplify serves over eleven million students in all 50 states.

The Amplify Data Analytics and Data Governance team is looking for a Data Entry professional. This role will assist various Customer Care and Support departments with manual data entry and manual data cleanup initiatives. To do well in this role you need a very fine eye for detail, outstanding typing skills, and familiarity with excel or google sheets. This is a short term contract position and could be perfect for students or teachers over the summer months.

Responsibilities:

  • Meet with Team lead briefly in the morning to raise any issues/concerns/roadblocks regarding your task assignments
  • Coordinate with departmental directors or their managers to gain an understanding of the data entry or data cleanup needs
  • Manage timeline and set expectations appropriately
  • Ability to self-manage, set and meet deadlines, and ask for help when needed

Basic Requirements:

  • At least 18 years of age
  • Proficient typing (and spelling) skills
  • Demonstrated knowledge of and skill in word processing and spreadsheets
  • Experience using:
    • G Suite
    • Google Sheets

Preferred Qualifications:

  • Experience with technologies and tools such as:
    • Salesforce/NetSuite
  • Process oriented with great documentation skills

We celebrate diversity and are committed to creating an inclusive environment for all employees. To that end, we seek to recruit, develop and retain the most talented people from a diverse candidate pool.

Amplify is an Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individuals with Disabilities.

This position may be funded, in whole or in part, through American Recovery & Reinvestment Act funds.

Amplify Education, Inc. is an E-Verify participant.

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Senior Data Entry Clerk

Employer: Robert Half International

Robert Half is candidates for a CONTRACT Senior Data Entry Clerk in the Healthcare industry for a client. This position is a REMOTE position for residents in the United States.

  • Preparing source data by opening and sorting emails
  • Verifying and logging received data
  • Checking data for deficiencies and establishing priority entry
  • Accurate, high speed data entry

The schedule for this role is based in central time and would be 8am-5pm CST, Mon-Fri.

Requirements

  • High school diploma or GED equivalent
  • 1-3 years of heavy data entry experience
  • 1-3 years’ administrative experience in Medical/Insurance settings
  • Strong typing, compute, and written skills

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Accounts Receivable Coordinator

Employer: Ferguson Enterprises

Ferguson is North America’s leading value-added distributor across residential, non-residential, new construction and repair, maintenance, and improvement (RMI) end markets. Spanning 34,000 suppliers and more than one million customers, we deliver local expertise, value-added solutions, and the industry’s most extensive portfolio of products. From infrastructure, plumbing, and appliances, to HVAC, fire protection, fabrication, and more, we make our customers’ complex projects simple, successful, and sustainable.

Ferguson is currently seeking the right individual to fill an immediate need for an Accounts Receivable Coordinator!

Role and Responsibilities:

  • Entry level Cash Application position.
  • Use Access data bases to facilitate workflow to clear UNST & POA payments on customer accounts as advised by branches and/or customers.
  • Post customer payments including lockboxes, scanned & EDI through AR Cash App software. Not a collections position.
  • Cash position will post $1M payments with hundreds of invoices across multiple locations
  • Analyze information provided by customers and branches to accurately post payments.
  • Research AR balances and/or payments in legacy or Oracle systems.
  • Send clear, complete, and appropriate communications to branches per department guidelines.
  • Entry level UNST/POA productivity requirements are 184 payments with 2% error rate.
  • Use available resources to effectively perform duties (Master List, Power BI, Regional Search, etc.)
  • Ability and willingness to vary hours and work overtime (which may include prolonged shifts, weekends and holidays) as necessitated by business needs.

Qualifications:

  • College degree preferred, but not required
  • Two years’ experience processing accounts receivable payments in a high volume, fast paced environment.
  • Experience with Billtrust and/or Oracle is preferred.
  • Highly organized, detail oriented and analytical
  • Effective time management skills
  • Knowledge of basic accounting concepts
  • Proven ability to work with a sense of urgency to meet deadlines
  • Strong written and verbal communication skills
  • Proficient in all Microsoft Office programs, especially Excel, Word, Outlook
  • Willingness to work in a productivity-driven environment with a high volume of workflow
  • Ability to problem solve and think analytically
  • Work independently and as a team to achieve goals
  • Ability to be highly productive, engaged and communicate in a remote environment

Ferguson is dedicated to providing meaningful benefits programs and products to our associates and their families—geared toward benefits, wellness, financial protection, and retirement savings. Ferguson offers a competitive benefits package that includes medical, dental, vision, retirement savings with company match, paid leave (vacation, sick, personal, holiday, and parental), employee assistance programs, associate discounts, community involvement opportunities, and much more!

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Data Entry Operator

Employer: Change Healthcare

Overview of Position

Provides analytical and specialized administrative

Analyzes problems, determines approach, compiles, and analyzes data, and prepares reports/recommendations.

Work is generally of a critical or confidential nature. Assignments may be found in various functional areas

What will be my duties and responsibilities in this job?

  • Perform administrative task as assigned
  • Identify any issues or trends and bring them to the attention of management team
  • Work on special projects as assigned
  • Other duties as assigned

What are the requirements needed for this position?

  • High School diploma, vocational training, or equivalent experience
  • 1+ years of administrative support experience
  • Ability to meet position performance goals
  • Strong written and verbal communication skills
  • Knowledge of Adobe Pro & Microsoft Excel spreadsheets

What other skills/experience would be helpful to have?

Experience working with clinical hospital systems.

Working in a virtual environment.

What are the working conditions and physical requirements of this job?

Remote work from home if in Pittsburgh region may be required to come into the office

How much should I expect to travel? none

Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!

COVID Vaccination Requirements

We remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. As such, we require all employees to disclose COVID-19 vaccination status prior to beginning employment and we may require periodic testing for certain roles. In addition, some roles require full COVID-19 vaccination as an essential job function. Change Healthcare adheres to COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance.

Equal Opportunity/Affirmative Action Statement

Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at eeoc.gov/employers/eeo-law-poster and the supplemental information at dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf.

If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to [email protected] with “Applicant requesting reasonable accommodation” as the subject. Resumes or CVs submitted to this email box will not be accepted.

Click here dol.gov/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf to view our pay transparency nondiscrimination policy.

California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcare’s Privacy Notice to California Job Applicants Regarding the Collection of Personal Information.

Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.

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