Wichita, Kansas
Medical Claims Representative / Health Plan Job Opening in Wichita, Kansas - A Claims Representative focuses on assembling information and processing complex and large dollar medical claims.
Essential Functions:
Process specialized claims obtaining pricing through an outside vendor
Research possible disclosure issues
Work in close coordination with Stop Loss Claims Processors
Develop and maintain an excellent working knowledge of policies in order to determine eligibility, benefits and assemble claims accurately
Must work within audit and established dollar limitations
Assist providers and members with questions regarding their claims or policies both in writing and verbally
Abide by HIPAA regulations and other privacy policies at all times
Maintain an exemplary attendance and tardiness record following established company guidelines
Demonstrate ability to work well with other departments and all Medova staff members
Complete other tasks, as assigned
Competencies:
Technical Capacity
Writing Skills
Problem Solving
Attention to Detail
Initiative
Required Education and Experience:
High School Diploma or equivalent
1-3 year of medical claims processing or medical billing experience including medical terminology and coding
1 year health insurance industry knowledge
Preferred Education and Experience:
Additional course work in the medical field
Computer Skills:
Microsoft Outlook
Microsoft Word
Microsoft Excel
Data Entry
Ten Key
Position Type and Expected Hours of Work:
Full-time
Office based - Downtown Wichita
Monday-Thursday 8am-5pm; Friday 8am-4pm (general)
At least a 30 minute lunch required daily
Job Type: Full-time
Job Location:
Wichita, KS
Required education:
High school or equivalent
Required experience:
medical claims processing: 1 year
medical billing: 1 year
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