Claims Processor I

Job not on LinkedIn

🔥 17 hours ago

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

⏰ Full Time

🟢 Junior

📋 Claims Specialist

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 12%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Blue Cross and Blue Shield of Louisiana

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1934

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross Blue Shield Association, offering a range of health insurance products and services in the state of Louisiana. The company provides health, dental, and travel insurance options, including Medicare Advantage plans such as HMO and PPO. They focus on delivering comprehensive healthcare coverage through various plans to meet varying customer needs, while partnering with doctors, hospitals, and clinics to ensure quality care and support. Additionally, the company emphasizes wellness programs, cost-saving opportunities, and accessibility for its members.

📋 Description

• Research and verify complex claims information for accurate and timely claims processing • Enter coded and other required information into claims systems • Review and correct scanned claims documents • Check claims for completeness and accuracy before final entry • Identify and resolve inconsistencies and request missing information • Ensure contract benefits are applied correctly • Research procedural questions using supporting documentation and training manuals • Identify incomplete adjudication instructions and suggest procedure updates • Identify training issues and consult management when necessary • Record daily production information including edits processed, hours worked, downtime, and special projects • Reject, redirect, or return incomplete or inaccurate claims • Maintain contact with internal departments, staff, providers, members, lawyers, insurers, and other external entities • Perform other job-related duties within the scope of responsibilities

🎯 Requirements

• High School Diploma or equivalent required • Associate's degree preferred • 1 year of related clerical or data entry experience required • A medical office or medical coding diploma can be used in lieu of one year of experience • Completion of the Medical Assistant, Coding & Insurance Pathway from BRCC can be used in lieu of one year of experience • Claims processing or claims coding experience preferred • Must be able to enter data at 4000 keystrokes per hour • Medical coding training preferred • Must demonstrate critical thinking and problem-solving skills • Familiarity with medical and health insurance terminology preferred • Demonstrated verbal and written communication skills • Must demonstrate PC skills including Microsoft Office (Word, Excel, Outlook, etc.) • No licenses or certifications required • Residency in or relocation to Louisiana is preferred for all positions • Must pass background and pre-employment drug screening; employment restrictions apply to certain felony convictions involving dishonesty or breach of trust

🏖️ Benefits

• Employee resources to live well, be healthy, continue learning, develop skills, grow professionally and serve local communities • Smoke- and tobacco-free company properties • Reasonable accommodations for individuals with disabilities • Pre-employment drug screening and background screening after an offer