This position is for Care1st Health Plan, a WellCare Healthplans, Inc. company.
Department: AZ- Ops Claims -Medicaid
Reports to: Operations Supervisor
Location: E. Camelback Rd, Phoenix AZ 85016
Job Type: Hourly/ Non-exempt
Researches and processes institutional and/or professional claims.
- Processes claims that pend for various hold reasons to assist in the final determination on claim disposition.
- Processes adjustments related to projects or provider disputes.
- Researches post payment claims issues and takes necessary action for correction.
- Research claims issues and works with other departments to resolve claim issues.
- Assists with special projects as assigned or directed.
- Arizona representatives may provide provider phone coverage two days a week
- Required A High School or GED
- Preferred 1 year of experience in Previous claims or health insurance
- Beginner Ability to multi-task
- Beginner Ability to work independently
- Beginner Ability to communicate and make recommendations to upper management
- Intermediate Demonstrated interpersonal/verbal communication skills
- Beginner Demonstrated written communication skills
- Beginner Demonstrated analytical skills
- Beginner Demonstrated problem solving skills
- Beginner Demonstrated time management and priority setting skills
- Beginner Demonstrated organizational skills
- Beginner Knowledge of healthcare delivery
- Required Beginner Microsoft Outlook
- Required Beginner Microsoft Word
- Required Beginner Microsoft Excel