Employer: Conduent
About Conduent
- Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments – creating exceptional outcomes for our clients and the millions of people who count on them.
- You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.
Job Description
- *Conduent is hiring REMOTE Reimbursement Review Services Associate – Medical Claims Adjuster*
- We need an upbeat, articulate and reliable Reimbursement Review Services Associate – Adjuster our Team.
- You will be adjusting already processed claims, voiding and reissuing checks and processing refunds.
- Training: Monday – Friday 9am – 5pm EST
- Work Hours: Flex schedule
- Pay: Non-exempt / hourly
- Full Time – regular position
- Equipment provided [Laptop & Headphones]
- This a Remote / WFH position
Requirements:
- Must be at least 18 years of age with at least a high school diploma or GED.
- Must pass a criminal background check.
- Must have WIRED internet connection, WIFI is not permitted.
- Must have previous Health Plan claims knowledge.
Preferred:
- Experience with Microsoft Office Excel.
- Medical Insurance experience.
- Medical office billing experience.
- Medical Claims experience.
Job Track Description:
- Performs tasks based on established procedures.
- Uses data organizing and coordination skills to perform business support or technical work.
- Requires vocational training, certifications, licensures, or equivalent experience.
General Profile
- Has a developed proficiency of analytical or operational processes.
- Completes atypical assignments.
- Works within established procedures and practices.
- May establish the appropriate approach for new assignments.
- Acts as a resource for colleagues.
- Completes work with limited supervision.
Functional Knowledge
- Has developed skills in a range of processes, procedures, and systems.
Business Expertise
- Understanding of how best teams integrate and work together to achieve company goals.
Impact
- Impacts a team, by example, through the quality service and information provided
- Uses discretion to change work procedures and practices.
Leadership
- May provide guidance and support to junior team members.
Problem Solving
- Provides solutions to atypical problems based on existing precedents or procedures.
Interpersonal Skills
- Exchanges information and ideas effectively.
Responsibility Statements
- Conducts medical and pharmacy benefit insurance verifications and investigations for commercial and government payers.
- Interprets patient insurance, prescription, and other health-related documentation.
- Researches available alternative funding options to reduce patient’s financial responsibility.
- Applies prescription drug benefit management techniques.
- Examines records to transcribe medical codes.
- Validates licensed practitioners.
- Performs other duties as assigned.
- Complies with all policies and standards.
Additional information
Where legally permissible, Conduent requires associates to attest to their COVID-19 vaccination status and may require proof of vaccination.
Closing
Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.
People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the “Submit†button at the bottom of the form. For those using Google Chrome or Mozilla Firefox please download the form first: click here to access or download the form. You may also click here to access Conduent’s ADAAA Accommodation Policy.