IN ORDER FOR YOUR APPLICATION TO BE CONSIDERED, YOU MUST COMPLETE A REQUIRED DATA ENTRY ASSESSMENT.  YOU ARE WELCOME TO COME IN TO OUR OFFICE LOCATED AT 7261 MERCY ROAD, MON.-FRI. BETWEEN THE HOURS OF 8:30 AM AND 3:30 PM TO COMPLETE THE DATA ENTRY ASSESSMENT. 

Major Job Function:

To process hospital, physician and subscriber-submitted claims for payment via PC in a timely and accurate manner and in compliance with MTM, MPA guidelines in order to achieve our BCBSN strategic goals.

Essential Job Functions
1. Reviewing claims to determine benefits based on specific member and provider contracts in a timely and accurate manner.
2. Research claims for adjudication information using various on-line manuals, files, and other various reference materials or resources as needed.
3. Electronically route claims to other departments for review by completing special forms and using workflow tools within our imaging system.
4. Perform other special projects as needed.

Knowledge, Skills and Abilities
1. Ability to sit for long periods of time.
2. Ability to meet high production and quality standards.
3. Must have the ability to maintain a positive attitude and be adaptable to change.
4. Must have a team attitude and be willing to work with diverse groups of employees and management.
5. Part time positions guaranteed 20 hrs. per week, 30 or more hrs. may be required during peak periods.
6. Part time positions have a flexible schedule M-F 7:00 a.m. to 5:30 p.m.
7. Full time positions must have the ability to work overtime as required during peak periods.
8. Experience working with medical terminology as well as ICD-9/CPT-4 coding.
9. Experience working with HCFA 1500 and UB 92 forms preferred.
10. Experience working with health insurance preferred.
11. Ability to keystroke 8,500 ksph (29 wpm) numerically (10-key adding machine)

Education, Training and Experience Required
1. High school diploma or equivalent.
2. One year experience working with insurance claims preferred.