POSITION SUMMARY:

The Under 65 Claims Clerical Support Unit is responsible for entering and processing claims, ensuring timely turnaround (1-2 days), and reviewing claim submissions for discrepancies. Individuals on the team are flexible with their work and manage their time accordingly based on work needs.

QUALIFICATIONS AND SKILLS REQUIRED:

Excellent communications skills (Both verbal and written)
Basic Word and Excel skills
Able to prioritize duties and effectively manage time
Ability to be flexible when needed, take initiative, and demonstrate accountability
Ability to work well within a team environment and participate in department/team projects
Must be customer service oriented High School or GED
Legal rights to work in the US

Enter claim details into the processing system (such as claim number, policy number, total charge, service date, provider, patient, etc.) to prepare claims for review by the claims examiners
Identify and report discrepancies in claims (e.g., incorrect patient names, birthdates, etc.)
Maintain a 1-2 day turnaround time from claim receipt to claim management
Review and log claims/documents submitted through the Policyholder Portal, Agent Portal, and any other referred portals within the company
Report any discrepancies or issues with claim submissions to leadership
Communicate any issues related to the portals to leadership
Ensure claims are processed as quickly as possible, aiming for a one-day turnaround time
Sort and distribute incoming mail within the U65 claims department