Hi, are you looking for Claims Processor – Entry Level jobs in Wilmington, DE 19801 ?
we got a perfect job opening for you !
Company name : Pathfinders Inc
Location : Wilmington, DE 19801
Position : Claims Processor – Entry Level
Description :
We are representing a new opportunity with one of our top clients. This is a great chance to work for a diversified company in the financial industry. Our client offers great benefits including PTO and holidays, tuition reimbursement, gym membership, strong health benefits, 401k matching and a strong career trajectory.
The ideal candidate will have a Bachelor’s Degree (minimum 3.0 GPA) and will be comfortable working in a detail oriented, analytical environment.
This is a great opportunity to join a well-established corporate team where you will have the opportunity to make an impact and start on a dynamic and strong carer path.
Reviews, analyzes and processes claims and appeals in accordance with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable language.
Utilizes guidelines and review tools to conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize and route to staff for review.
The grievance and appeal work is subject to applicable accreditation and regulatory standards and requirements.
As such, the analyst will strictly follow department guidelines and tools to conduct their reviews.
Responsibilities exclude conducting any utilization or medical management review activities which require the interpretation of clinical information.
The analyst may serve as a liaison between grievances & appeals and /or medical management, legal, and/or service operations and other internal departments.
Job Type: Full-time
Pay: $16.00 – $20.00 per hour
Benefits:
401(k)
Health insurance
Paid time off
Schedule:
8 hour shift
Education:
Bachelor’s (Required)
Work Location: One location
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