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Intake Claims Rep

Kelly Services Lombard Full-Time
$0.00 - $16,000.00 / year
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Intake Claims Rep – Lombard, IL Contract to hire Pay Rate $16/hr Training will be provided 4-6 weeks. After training is complete, the hours will be 9am to 5:30pm. BASIC FUNCTION: Under Supervision, this position is responsible for administrative claim setup as well as initial claim review, assisting in claim coding, including but not limited to: Eligibility assessment, determine coverage amounts, editing member data in the billing systems, policy requirements, Investigates, researches, and diligently obtains required information on all types of claims types and Payment Procedures.      ESSENTIAL FUNCTIONS:

  • Evaluates and reviews claims to determine coverage amounts, eligibility, identification of beneficiary(ies), policy requirements and payment procedures.
  • Contacts Beneficiary, Employer and/or Broker to notify by telephone or letter and verify questionable information submitted on claims.
  • Creates, reviews and edits member and benefit information including Self-Administered Billing, Self-Administered Billing-Web, Third Party Administrators, spouse and dependent coverages.
  • Updates party records and roles, benefit cases and benefit entitlements as it relates to claims. 
  • Completes Intake scripts.
  • Adheres to quality, production, service and departmental guidelines to complete claims with diligent follow ups.
  • Acquire thorough knowledge of all policies, state statutes, regulations, ERISA, and departmental procedures to ensure proper handling or management of claims, while in the role.
  • Proactively identifies inconsistencies or lag in claim information and utilizes effective approaches and resources to obtain clarification or verification.
  • Maintains accurate documentation of activities in claim file in accordance with company practices and procedures.
  • Recommends changes to management to avoid recurring customer inquiries/problems.
  • Provide professional, prompt and accurate customer service to both internal and external customers, effectively and professionally represent the company in all interactions.
  • Adhere to quality, production and departmental guidelines.
  • Communicate and interact effectively and professionally with co-workers, management, customers, etc.
  • Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
  • Maintain complete confidentiality of company business.
  • Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.         
  • Identify, research & code the following claim types: Life, Waiver of Premium, Critical Illness/Specified Disease, Accidental Insurance, GAP, Accidental Death, Dismemberment, Permanent and Total Disability (PTD), Accelerated Death Benefits, and Secured Claims.

    JOB REQUIREMENTS:

  • Associate’s Degree OR High School Diploma/GED and equivalent of 1 year of business experience
  • Problem solving and research skills PC proficiency to include Word, Excel, PowerPoint, Outlook and Lotus Notes
  • Customer Service experience.
  • Organizational skills.
  • Ability to handle multiples tasks and priorities effectively
  • Clear and concise verbal and written communication skills.

Additional Detail:

  • We appreciate all our applicants, but we are not able to sponsor now; no C2C or H-1B. No third-party suppliers.
  • There is no ‘per diem’ with this position, and must be able to work on W-2 hourly basis.
  • There is no relocation budgeted for this position. If this position requires you to relocate you will be responsible for those costs.
  • As your local offices do not support this position, for immediate consideration, please apply online to this posting directly.
  • Resumes in MS Word are preferred.
  • If you have questions about the position, you may contact the recruiter at URL blocked - click to apply; however, your resume must be received via the official posting.



Why Kelly®?


As a worker today, it’s up to you to take charge of your career and look for opportunities to learn, grow, and achieve your potential. Helping you find what’s next is what we’re all about. We know what’s going on in the evolving world of work—just ask the nearly 500,000 people we employ each year. Connecting with us means getting the support, guidance, and opportunities needed to take your career where you may have never imagined.



About Kelly®


At Kelly, we’re always thinking about what’s next and advising job seekers on new ways of working to reach their full potential. In fact, we’re a leading advocate for temporary/nontraditional workstyles, because we believe they allow flexibility and tremendous growth opportunities that enable a better way to work and live. Connecting great people with great companies is what we do best, and our employment opportunities span a wide variety of workstyles, skill levels, and industries around the world.

Kelly is an equal opportunity employer committed to employing a diverse workforce, including, but not limited to, minorities, females, individuals with disabilities, protected veterans, sexual orientation, gender identity. URL blocked - click to apply

 

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