Claims Processor in Wixom, MI at Beacon Health Options

Date Posted: 6/20/2019

Job Snapshot

Job Description

About the Position:

Beacon Health Options is currently seeking a dynamic Claims Processor to join our team in Wixom, MI! The Claims Processor will be responsible to process claims promptly and accurately in accordance with the Department and Company policies and procedures. 

Position Responsibilities:

  • Verify the accuracy of claims data entered by a data entry clerk and accurately complete the data entry of additional claims data necessary to adjudicate the claim. 
  • Research claims for additional or missing information. 
  • Utilize pre-established screening guidelines and templates to review claims information to determine member eligibility, level of benefits and if claims should be paid. 
  • Route claims information to appropriate departments for action, if necessary. 
  • Review open claims’ reports on a daily basis  to ensure that claims are processed quickly and accurately while meeting Departmental accuracy, productivity and performance standards
  • Process mailbacks and submit for audit.
  • Complete daily production logs and turn them in daily to the Claims Department Manager by the end of shift or before leaving for the day.
  • Ensure that any data required for reporting purposes is entered as instructed by auditor or directed by management.
  • Promptly raise any issues delaying resolution of the claim to management.
  • Contribute to overall success of the claims department in meeting performance guarantees to customers and maintaining customer standards. 

Position Requirements:

  • Education: High school diploma or GED equivalent required
  • Licensure:  Claims/Billing certification from an accredited business institution preferred
  • Relevant Work Experience: 1 year of claims processingor medical billing experience required
    • Certification from an accredited business institution related to billing/claim administration and 6 months office/clerical experience may be substituted
  • Knowledge, Skills, & Abilities:
    • Knowledge and experience using management information systems and software
      • CAS or other computerized claims processing system
      • Word processing and spreadsheet applications
    • Ability to utilize pre-established screening guidelines and templates with accuracy
    • Ability to key with accuracy and pass a test of data entry skills

To Apply:

Click below on “Apply for this Position” to create a profile and apply for the position

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disabled

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

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