Customer Service/Medical Claims Processor

CARDAY ASSOCIATES, INC.
Columbia, MD Full-time
Posted on April 30, 2019

Carday Associates, Inc. provides administrative and consulting services to a variety of Benefit Funds. Our clients include many Taft-Hartley Multi-employer Benefit Funds, multiple employer Funds and local unions. We have served the benefits community with pride since 1952.

 

Candidates must have exceptional communication skills, the ability to manage high volume of calls from both members and providers, handle multiple tasks efficiently, and can work productively in a fast-paced, team-oriented environment.  Prior experience in medical claims processing, knowledge of CPT, ICD-10 codes and medical terminology.  Bilingual (English/Spanish) required.  Forward resume via fax @ 410-872-9530 or hr@cardayassociates.com

 

Primary Responsibilities: 

  • Process manual claims, consistently meeting productivity and quality standards.
  • Verify eligibility of member.
  • Enter appropriate claims into claims platform, confirm accuracy of result and make appropriate changes if necessary.
  • Keep management informed of actual or potential system or procedural problems, plan set - up questions and need for system corrections to accurately process claims.
  • Correctly process returns for any claims that cannot be entered into the system.
  • Work with management to address escalated issues or claims with problems.
  • Adhere to all individual employee performance standards including but not limited to productivity, quality and attendance.
  • Other duties and projects as assigned.
  • Adhere to all company and departmental policies and procedures.

Required Qualifications:

  • High School Diploma / GED (or higher).
  • 1+ years of medical claims processing experience and customer service experience.
  • 1+ years of work experience working on a computer in Windows applications with the ability to learn other complex computer systems.
  • Experience planning and prioritizing job tasks within deadlines.
  • Work efficiently and accurately meeting timeline expectations.
  • Strong attention to detail.
  • Interact with others in a positive, professional manner.