Claims Processor - Hybrid

Title: Claims Processor - Hybrid

Mandatory skills:

MS Office, Typing, WPM, Keys, Data Entry, Facets, IMAX, MS Access, Access, Windows, ICD 9, ICD 10, HIPAA, CPT, Excel, PIVOT Tables, VLOOKUP, FACETS, Exclaim,,
claims processing, data entry, PCs, spreadsheet applications,
processing insurance claims, claims adjudication,
production, benefit designs, customer service, Information Systems,
Key Performance Indications, claims system, Metastorm, Exclaim, EyeNet,
software programs, Excel, Access

Description:

Processor

GENERAL FUNCTION:

Accurately and efficiently processes manual claims and other simple processes such as claims projects. Through demonstrated experience and knowledge, process standard, non-complex claims requiring a basic knowledge of claims adjudication.

MAJOR DUTIES & RESPONSIBILITIES:

Processing - Efficiently and accurately processes standard claims or adjustments
Consistently achieves key internals with respect to production, cycle time, and quality
May participate on non-complex special claims projects initiatives, including network efforts
Understands and quickly operationalizes processing changes resulting from new plans, benefit designs.
Drive client satisfaction - Works with supervisor and co-workers to provide strong customer service and communication with key customer interfaces that include the client Account Managers, Operations, Information Systems, Client Representatives and the client leadership team
Drives Key Performance Indications - Consistently meets or exceeds agreed upon performance standards in both productivity and accuracy
Proactively works with supervisor to develop self-remediation plan when standards are not being met

KNOWLEDGE & SKILLS:

Data entry and claims processing knowledge
Has a working knowledge of interface systems that include the client claims system, Metastorm, Exclaim and EyeNet
Some basic working knowledge of software programs, specifically Excel and Access
Understands third party benefits and administration
Strong customer service focus
Ability to work well under pressure and multi-task

EXPERIENCE:
0-1 years of claims processing/data entry experience. Knowledge of PCs and spreadsheet applications

EDUCATION:

High school mandatory

In addition; Model of Care, ODAG, FSL Fraud Integral Staff training, CA Fair Claims.

Specific Skills/experience needed:

Excel skills, effective communication skills, analytical skills, experience processing insurance claims

Note:

Estimated Hours Per Week: 40 / week
Work Hours: 8-5 (1 hr lunch) or 8-4:30 (1/2 lunch)
Hybrid - 3x a week(Tuesday, Wednesday and Thurs); Training 100% on site.

VIVA USA is an equal opportunity employer and is committed to maintaining a professional working environment that is free from discrimination and unlawful harassment. The Management, contractors, and staff of VIVA USA shall respect others without regard to race, sex, religion, age, color, creed, national or ethnic origin, physical, mental or sensory disability, marital status, sexual orientation, or status as a Vietnam-era, recently separated veteran, Active war time or campaign badge veteran, Armed forces service medal veteran, or disabled veteran. Please contact us at for any complaints, comments and suggestions.

Contact Details :

VIVA USA INC.
3601 Algonquin Road, Suite 425
Rolling Meadows, IL 60008
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