Jobs Working From Home ( Claims Representative )
Hiring Organization: The Cigna Group
Post Name: Claims Representative
Qualification: Graduate
Industry: Private
Employment Type: Full Time
Work Hours: 8 Hours
Salary: £20 – £30/Hour
Location: Connecticut, USA
Full Job Description:
Assist our customers keep their health, well-being and experience of protection through making sure clinical claims are processed appropriately and well timed while protective the confidentiality of our consumer's non-public fitness information. Below direct supervision plays obligations referring to the claims adjudication technique from evaluation of the declare shape, verification of eligibility, verification of coordination of advantages with insurance carriers, and finalizing based on the fitness advantages plan. Technical recommendation and help may be supplied by using Technical Coaches.
Jobs Working From Home ( Claims Representative )
Obligations
- Overview claim submissions to affirm required documents were acquired, affirm clinical codes, eligibility, different coverage, authorizations, and account benefit plans.
- Follows installed guidelines and strategies to pay, pend for added facts, or deny claims.
- Adapt to and positively have an impact on trade with the aid of accepting comments with a boom attitude to continuously improve.
- Observe techniques and paintings independently to meet or exceed Key overall performance signs (KPI)
- Capability to correctly excel in a virtual paintings surroundings thru lively participation in group huddles, supervisor 1x1 or take a look at-ins, the use of a ramification of digital equipment, i.E. Outlook electronic mail, Skype for commercial enterprise, Cisco internet-Ex or different comparable applications.
- Keeps a high stage of accuracy in all duties finished.
- Crew members might be held liable for assembly and retaining minimal exceptional and manufacturing standards through use of control running structures (MOS) gear: each day manufacturing Log (DPL), overall performance Profile, declare evaluation device, and different reporting systems.
- Associate with the resource control organization (RMG) on Workflow device (WFT), pended claims, or other stock problems.
- Associate with Technical Coaches to understand declare techniques and approaches.
Experience Required
- Must possess robust interest to detail and trouble-solving competencies with a high degree of accuracy
- High degree of laptop navigational skills with enjoy using shortcut keys
- Talented in Microsoft office applications, word, Excel, Outlook, OneNote, and energy point
- Information of scientific and coverage enterprise terminology which includes CPT/ICD-10 codes favored
- Scientific coding expertise preferred
- Extraordinary organizational, interpersonal, written and verbal conversation capabilities
- Revel in in delivering remarkable customer service
- Potential to perform easily in a quick-paced, deadline-oriented work surroundings
- Must be capable of kind and use a keyboard for extended intervals of time
- Integrity and personal duty for activity overall performance and expectancies
- Validated capacity to research a spread of benefit plans
Jobs Working From Home ( Claims Representative )
