We use cookies. Find out more about it here. By continuing to browse this site you are agreeing to our use of cookies.
#alert
Back to search results
Remote

Claims Examiner - CSR

Firstsource
medical insurance, dental insurance, life insurance, vision insurance, flexible benefit account, paid time off, 401(k), employee discount
United States
Jan 15, 2025

About Firstsource

Firstsource Solutions is a leading provider of customized Business Process Management (BPM) services. Firstsource specializes in helping customers stay ahead of the curve through transformational solutions to reimagine business processes and deliver increased efficiency, deeper insights, and superior outcomes.

We are trusted brand custodians and long-term partners to 100+ leading brands with presence in the US, UK, Philippines, India and Mexico. Our 'rightshore' delivery model offers solutions covering complete customer lifecycle across Healthcare, Telecommunications & Media and Banking, Financial Services & Insurance verticals.

Our clientele includes Fortune 500 and FTSE 100 companies.

Job Title:Claims Analyst Customer Service Representative

Job Type:Full Time

FLSA Status:Non-Exempt/Hourly

Grade:H2

Function/Department:Health Plan and Healthcare Services

Reporting to:Team Lead/Supervisor - Operations

Pay Rate: $20/hr

Job Description

We are seeking a highly-motivated and success-driven Medical Insurance Claims Representative who combines exceptional analytical and problem-solving skills, with the ability to positively adapt to change in a dynamic fast-paced environment. It is also vital that you display exceptional verbal and written communication, negotiation and active-listening skills, as well as the ability to work effectively in an environment with fluctuating workloads.

Qualifications

The qualifications listed below are representative of the background, knowledge, skill, and/or ability required to perform their duties and responsibilities satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.

Education

* High School diploma or equivalent required

Work Experience

* Health claims processing experience required, including BLUE PLANS experience

* Contact Center experience of 2 - 4 years

* Claims examiner experience 4 - 6 years

Competencies & Skills



  • High School diploma or GED
  • Health claims processing experience required
  • Knowledge in the following:
  • medical terminology
  • ICD-9/ICS-10, CPT, and HCPCS coding
  • HIPAA regulations
  • PC applications and systems
  • Blue Plans
  • Ability to read and interpret general business correspondence, procedure manuals, and specific plan documents
  • Basic mathematical skills
  • Intermediate typing skills
  • Multiple computer application usage experience


Additional Qualifications

* Ability to download 2-factor authentication application(s) on personal device, in accordance with company and/or client requirements

* Ability to pass the required pre-employment background investigation, including but not limited to, criminal history, work authorization verification and drug test

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This position may work onsite or remotely from home.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Must be able to regularly or frequently talk and hear, sit for prolonged periods, use hands and fingers to type, and use close vision to view and read from a computer screen and/or electronic device. Must be able to occasionally stand and walk, climb stairs, and lift equipment up to 25 pounds.

Firstsource is an Equal Employment Opportunity employer. All employment decisions are based on valid job requirements, without regard to race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, age, disability, genetic information, veteran status, or any other characteristic protected under federal, state or local law.

Firstsource also takes Affirmative Action to ensure that minority group individuals, females, protected veterans, and qualified disabled persons are introduced into our workforce and considered for employment and advancement opportunities.

Benefits:



  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Employee assistance program
  • Employee discount
  • Flexible spending account
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance



Schedule:



  • 8 hour shift


Applied = 0

(web-6f6965f9bf-tv2z2)