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.
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.
- 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.
- 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.
- 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.
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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
Complex Problem Solving