Claims Processor I

Job not on LinkedIn

🕒 2 days ago

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

⏰ Full Time

🟢 Junior

📋 Claims Specialist

🚫👨‍🎓 No degree required

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Blue Cross and Blue Shield of Louisiana

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1934

⚕️ 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

• Researches and verifies complex claims information to ensure the accurate and timely processing of claims. • Enters all information needed to process claim • Identifies inconsistencies and makes necessary corrections. • Accountable for complying with all laws and regulations associated with duties and responsibilities. • Reviews and corrects scanned claims documents upon receipt as well as enters coded information. • Checks claims for completeness and accuracy of information prior to final entry, while identifying and resolving inconsistencies. • Appropriately returns claims requesting missing information in accordance with established quantity, quality, and timeliness guidelines ensuring contract benefits are applied correctly. • Consistently researches procedural questions using supporting documentation while identifying incomplete adjudication instructions. • Maintains and records information necessary for accurate recording and calculation of production. • Rejects, redirects misrouted or sends back claims when information is incomplete or inaccurate to facilitate timely processing.

🎯 Requirements

• High School Diploma or equivalent required • Associate's is preferred • 1 year of related clerical or data entry is required • A medical office or medical coding diploma can be used in lieu of the one year of experience • Completion of the Medical Assistant, Coding & Insurance Pathway from BRCC, can be used in lieu of the one year of experience • Claims processing or claims coding experience is preferred • Must be able to enter data at 4000 keystrokes per hour • Medical coding training is preferred • Must be able to demonstrate critical thinking and problem solving skills • Familiarity with medical and health insurance terminology preferred • Demonstrated verbal and written communication skills with the ability to interpret and communicate information with tact, diplomacy, patience and professionalism. • Must demonstrate PC skills including Microsoft Office (e.g., Word, Excel, Outlook, etc.).

🏖️ Benefits

• We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities.