Job details
Job type full-time
Full job description
In order to apply for a position at lumeris, you must create an account using your email address and a password of your choosingThis account will allow you to receive notifications each step of the way through the job application processWith these updates, you’ll never have to wonder where you are in the processAdditionally, we can easily send pertinent documents to you for your reviewOnce you create the account, you may apply to any position you feel is a good fit without having to re-enter informationThank you for your interest in lumeris.
Position:
Claims analyst (remote nationwide)
Position summary:
Job profile summary
The claims analyst is a part of the services team and is responsible for researching and processing moderately complex claimsThese claims are both paper and electronic and follow cms guidanceThe claims analyst applies specific and market focused processes to provide service support to clients as neededThis role includes solving claims issues, detailed reporting, adjustments and escalations.
Job description:
Primary responsibilities
Investigates and processes moderately complex claims
Handles challenging situations and acts with appropriate level of urgency when necessary
Follows precise instructions when processing claims
Completes assigned work and maintains production and quality standards
Extensively interacts cross-functionally to support resolution of claim issues
Researches and resolves adjustment inquiries
Performs edit resolutions from pended paper and electronic claims using critical decision-making skills for accurate claims processing
Works complicated reports, which involves critical decision making on adjustments, overrides of copayments, coinsurance, correct pricing and provider selection
Performs side by side comparisons to determine corrected claim actions
Issues letters & forms when appropriate
Performs initial overpayment recoupment process in the overpayment application
Lumeris is an eeo/aa employer m/f/v/d.
Location:
Addison, tx, addison, tx, ann arbor, mi, apollo beach, fl, arlington, tx, atlanta, ga, austin, tx, baltimore, md, barrow, ga, bartow, fl, baton rouge, la, boston, ma, brandon, fl, braselton, ga, carson city, nv, charlotte, nc, chicago, il, clearwater, fl, columbus, oh, dade city, fl, dallas, tx, dayton, oh, denver, co, detroit, mi, durham, nc {+ 37 more}
Time type:
Full time
Job type: full-time
Work location: multiple locations
