Non Customer Service Healthcare Claims Adjudication Team Member

Education Mandatory : Any Graduate (BSC/BCOM/BA)

Desirable : Nil Experience Minimum 6 Months eligibility/enrolment experience (preferred)

Technical Competencies : (Job related) Exceptional data entry skills with high attention to detail, strong organization skills and ability to multi-task Should have working knowledge of MS-Office: (Teams, Outlook, Excel, Word, OneNote)

Soft Skills : (Job related)

• Effective verbal and written communication skills and excellent interpersonal skills
• 
  Ability to work effectively with team members, employees/members, providers, and clients and vendors
• Ability to use common sense understanding to carry out instructions furnished in oral, written or diagram form
• Flexible; open to continued process improvement, with a positive attitude and willingness to learn
• Ability to work remotely; o Secure, reliable high speed internet access
• HIPAA complaint workspace; preferably in a room that can be secured
• Ability to work independently and free from distractions to productivity and accuracy
• Demonstrated critical thinking and problem-solving skills Others

Mandatory: Nil Desirable:

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  Bachelors degree
• 1 year Eligibility experience
• Prior EDI experience (ANSI 834s)
• Prior experience in a medical office or provider billing environment
• Self-Funded Insurance/Benefits and/or TPA experience
• Prior experience with COBRA, FMLA, LOA and retiree administration/coordination experience.
• Knowledgeable in handling various types of Federal, State and Company leave programs.
• Customer service experience in a professional setting
• Prior PowerStepp or other AS400 system experience
• Knowledge of COBRA laws, HIPAA portability and eligibility laws