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Claims Specialist (Contract--4449)

Company: OLSA Resources
Location: Philadelphia
Posted on: December 6, 2017

Job Description:

Job Description The World's Leading Healthcare Company is looking for a Claims Specialist to join their team! Job Description:As a Claims Specialist you will be responsible for accurate and timely handling of claims issued for all lines of business, including Bi-Directional sharing, FEP, Local and Commercial PA and AHNJ, BlueCard and Government Market. Will need to be able to apply and maintain knowledge of claims processing and support systems. Responsibilities:

  • Research inquiries received from all areas, inclusive of internal and external sources (e.g. other plans, providers, legal, Sales); as required, perform member or provider payable claim payment adjustments when appropriate following the correct processing guidelines.
  • Meet departmental quality and production requirements
  • Respond professionally to internal and external inquiries, as appropriate, while maintaining corporate and departmental standards.
  • Research claims that are paid incorrectly; recover overpaid and underpaid claim dollars from multiple sources and ensure all necessary transaction steps are taken to accurately process claim adjustments.
  • Provide response to general questions within expected departmental standards of initial inquiry; provide daily feedback, status updates and targeted resolution dates for more complex issues.
  • Complete special projects and participate in work groups as assigned.
  • Perform other duties as necessarySkills and Abilities:
    • Ability to demonstrate math and comprehension skills--required
    • Good interpersonal skills for handling internal and external customers
    • Well-developed listening, verbal and written communication skills.
    • Proficiency with Microsoft Office, specifically Excel and Word is required.
    • Ability to research and investigate information using multiple sources, operating systems and documented guidelines.
    • Must have strong organizational skills and problem solving ability.
    • Must be detail-orientedEducation/Experience:
      • High School Diploma or equivalent work experience.
      • 1-3 years of work experience in a production environment Additional Information:Schedule: Mon-Fri 7:00am-5:00pmDuration: 3-4 MonthsLocation: Philadelphia, PAPay Rate: DOECompany DescriptionFor the past 20 years, OLSA Resources has been a renowned supplier of top talent to Fortune 500 companies throughout the United States.OLSA Resources is recognized as one of the top 50 Woman-Owned Businesses, and has received the Best of Portland Engineering Award.Please bookmark our webpage to refer to during your career search as we are adding new opportunities daily: http://www.olsaresources.com/

        Keywords: OLSA Resources, Philadelphia, Claims Specialist (Contract--4449), Other, Philadelphia, Pennsylvania

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