Work At Home Job Alert! Claim Processor




Hello!

If you're searching 👀 for a work at home position BroadPath has quite a few jobs available. Today, I'm highlighting the Claim Processor position. Read on to learn more.


Job Description


Grow with a company that is passionate about helping you maximize your full potential! Become a part of transforming customer and client experience through the utilization of our innovative work from home technology. At BroadPath we believe in assuming the highest intention for others, our employees are empowered through their voices. BroadPath is thrilled to be hiring Claims Processors! Claims Processors will review and process medical and hospital claims, which include specialty services, emergency room visits, in-patient and out-patient claims for services rendered.


Responsibilities


*Review claims for billing, coding accuracy and completeness. 
*Process in accordance to all Plan, Federal and State provisions. 
*Evaluate claims for and report out suspected fraud, waste and abuse. 
*Use enterprise claims processing platform and ancillary supporting data bases and systems to research and/or retrieve key information necessary to support claims processing. 
*Meet or exceed productivity and quality expectations as detailed in the Claims Department Performance Plan. 
*Represent and demonstrate a thorough knowledge of both medical and hospital claims billing requirements, regulatory guidelines and the Plan Benefits applicable to each of the Affinity Health Plan product lines of business. 
I*dentify problems or questionable claim situations, resolve issues where appropriate, and refer to Claims Resolution Specialist for guidance. 
*Generate letters requesting additional information required to support proper claim determinations as well as denial letters to providers and Members as deemed appropriate. 
*Work cooperatively with Staff throughout the company and contribute to the overall success of the Claims Department. 
*Prepare weekly/monthly reports of claims activity, tracking claims processed against performance plan goal. Complete and submit all reports or other documentation required by Management, in a timely manner. 
*Perform other duties as necessary or required.

Click 👉 HERE if you're interested in applying for the job. Good luck!


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