Beacon Hill was founded to set a new standard in search, career placement and flexible staffing.
JOB DESCRIPTION
* Process, adjust or update various moderate to complex claims payments and payment errors for any business segment and/or claims-provider type
* Respond promptly and accurately to inquiries from Customer Service Professionals, subscribers, providers, physicians and other insurance carriers regarding claims payments.
* Meet or exceed established quality and performance standards
* Determine suspended claim resolution methods by reviewing benefit eligibility, claims history and other information
* Escalate claims requiring specialized resolution to subject matter experts based on department policies and guidelines to ensure the resolution
* Understand business requirement for the customer and provider segments with tailored solutions to their needs
* Identify system issues by documenting the issue, recommend potential solution and refer appropriate technical staff
* Work with designated Provider Services specialists to deliver services tailored to the provider services
* Review claims for possible "fraud and abuse" and send to Special Investigations Unit for additional investigation
* Use continuous improvement and knowledge of claims to drive efficiency and production gains; share best practices
* Coordinate with other insurance carriers and Medicare to determine payment liability
* Represent Claims interests on divisional or enterprise project teams
Hiring Requirements
* High school diploma or GED
* 3+ years of experience in related field.
Beacon Hill is an equal opportunity employer and individuals with disabilities and/or protected veterans are encouraged to apply.
California residents: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
If you would like to complete our voluntary self-identification form, please click here or copy and paste the following link into an open window in your browser: https://jobs.beaconhillstaffing.com/eeoc /
Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for reporting purposes only and will be kept separate from all other records.
Company Profile:
Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, a commitment to project completion and success and a passion for innovation, creativity and continuous improvement.
Our niche brands offer a complete suite of staffing services to emerging growth companies and the Fortune 500 across market sectors, career specialties/disciplines and industries. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs.
Learn more about Beacon Hill and our specialty divisions, Beacon Hill Associates, Beacon Hill Financial, Beacon Hill HR, Beacon Hill Legal, Beacon Hill Life Sciences and Beacon Hill Technologies by visiting www.bhsg.com .
Benefits Information:
Beacon Hill offers a robust benefit package including, but not limited to, medical, dental, vision, and federal and state leave programs as required by applicable agency regulations to those that meet eligibility. Upon successfully being hired, details will be provided related to our benefit offerings.
We look forward to working with you!
Beacon Hill. Employing the Future (TM)
Apply here: https://www.aplitrak.com/?adid=YmJnZW5lcmljLjkzNzc2LjEwNTA4QGJlYWNvbmhpbGxjb21wLmFwbGl0cmFrLmNvbQ
