PatriotRN
  • 21-Sep-2018 to 31-Dec-2018 (PST)
  • Carmel, IN, USA
  • 18.00
  • Hourly
  • Full Time

Medical, Dental, Vision, 401(k)


Ideal Position For Recent Grad or Individuals Studying for CPA or Actuary Exams

GENERAL JOB DUTIES:

  • Adjudicate routine home and facility based claims for long-term care (LTC) products
  • Review and pay claims according to claimant's policy and prescribed plan of care. Verify the provider of care is appropriate and in accordance with contract language and government regulations regarding healthcare providers and matches the plan of care for the associated dates of service
  • Determine benefit eligibility and payable amounts based on policy language and client's required procedures
  • Apply knowledge concerning state and federal regulations of the health-care industry, government-funded programs, and private insurance, including HIPAA
  • Detail-oriented, strong organizational skills, creative problem-solving skills
  • Knowledge and skills in Microsoft Office software packages including Outlook, Word, Excel, etc.
  • Excellent verbal and written communication skills and customer service skills. Must be able to create and write business letters
  • Excellent interpersonal skills
  • Ability to investigate and research claims
  • Aptitude to perform benefit calculations
  • Demonstrated ability in telephone skills, including experience in requesting additional information and customer service
  • Customer focused toward internal and external clients
  • Knowledge of basic office procedures
  • Flexible with the ability to work on multiple tasks

 

OTHER JOB REQUIREMENTS:

  1. Attendance
    a.  Is consistently present and punctual, and meets company standards
    b.  Provides proper advance notification for absence or tardiness
  2. Protocols and Policies
    a.  Demonstrates understanding of company-wide and department-specific policies and protocols
    b.  Maintains the confidential and proprietary nature of company policies and client's businesses
  3. Needs to be able to perform work accurately and efficiently under deadline pressures
  4. Meet quality and performance metrics 98% Financial Accuracy and 96% Procedural Accuracy
  5. Responsible for day-to-day decisions and updating management on department activity status

 

EDUCATION/EXPERIENCE:

Ideal candidate is recent college graduate with B.S. or B.A. in Math, Actuary Sciences, Economics, Statistics, Finance, Accounting, etc.

Will consider associates degree or equivalent formal training program (e.g. military service), and/or two years experience in claims/insurance industry.

NOTE: This is not a call center position

References Required ' including history of great attendance

 

RECRUITMENT / HIRING OVERVIEW:

1. Online testing - approximately 35 minutes to complete

2. Initial phone interview by recruiter based on resume submission

3. Onsite interview at Carmel office

 

We will not discriminate in our employment and employment-related decisions against any applicant or employee based on age, race, gender, creed, religion, national origin, disability, marital status, covered veteran status, sexual orientation, status with respect to public assistance, membership or activity on a local commission, or any other characteristic protected under state, federal, or local laws.

Job Type: Full-time

Salary: $18.00 /hour

PatriotRN
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