Florida Blue
Florida Blue - Service Advocate III Claims, REMOTE QIP
This job is now closed
Job Description
- Req#: 33128
Employer Industry: Healthcare Insurance
Why Consider this Job Opportunity:
- Competitive pay up to $26 an hour
- Opportunity for career advancement and growth within the organization
- Comprehensive benefits package including medical, dental, vision, and life insurance
- Retirement savings plan with employer contribution and match
- Paid time off, volunteer time off, and 11 holidays
- Comprehensive wellness program
What to Expect (Job Responsibilities):
- Day-to-day processing of claims for Federal Employee Program Institutional claims
- Review and adjudicate high-risk claims
- Process aged listings and held claims
- Determine whether to return, deny, or pay claims following contract benefit and organizational processing guidelines
- Actively seek, identify, and implement process improvement opportunities
What is Required (Qualifications):
- 0-1 years related work experience, with 2 years preferred in medical claims processing or claims adjudication in the healthcare industry
- High school diploma or GED
- Knowledge of CPT and ICD 9 and ICD 10 coding
- Knowledge of Medicare, HIPAA, and coordination of benefits
- Proven judgment, decision-making skills, and the ability to analyze
- Ability to learn quickly and multitask
- Motivated with a sound work ethic
- Concise written and verbal communication skills
- Proficiency in using Microsoft Windows and Word, Excel, Outlook
- Data entry and 10-key by touch/sight
How to Stand Out (Preferred Qualifications):
- Experience as a claims examiner or with adjudication experience on a computerized claims payment system in the healthcare industry
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Florida Blue offers affordable health insurance plans to individuals, families, and businesses. Explore our medical, dental, and Medicare health care plans.
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