Claims Technician - Full Time CAREER opportunity

Every day, Kelly Services connects professionals with opportunities to advance their careers.  We currently have exciting Temp-To-Hire opportunities for Claims Specialist in Wichita Falls, TX!!

BASIC FUNCTION:

Under supervision, this position is responsible for processing complex claims requiring further investigation, including coordination of benefits, and resolving pended claims.

ESSENTIAL FUNCTIONS:

This position is responsible for one or more of the following:

  1. Process complex claims in various queues. Conduct research and investigation into missing information, make phone calls to providers, access resource materials and support files in order to process and adjudicate claims timely and accurately.
  2. Resolve complex pended claims, duplicate claims and adjustments.
  3. Process claims, involving communications with participating plans and/or Service Units. Resolve various issues.
  4. Research and identify other insurance, Medicare, Medicaid and update patient file as needed.
  5. Coordinate benefits; request explanation of benefits as needed.
  6. Maintain a working understanding of medical terminology and CPT, HCPCS, and ICD9 coding.
  7. Maintain knowledge of pre-existing condition and waiting period requirements as they relate to specific contracts. Resolve error messages as they relate to pre-existing conditions.
  8. Read appropriate files in IMAGE and apply information to claims as needed using the Financial Suspense System (FSS).
  9. Prepare reports.
  10. Maintain files and records.
  11. Learn and maintain knowledge of DOL ERISA and prompt pay legislation.
  12. Assist with testing system changes and enhancements.
  13. Periodic overtime may be required at the sole discretion of the employer based on business need.
  14. Communicate and interact effectively and professionally with co-workers, management, customers, etc.
  15. Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
  16. Maintain complete confidentiality of company business.
  17. Maintain communication with management regarding developments within areas of assigned responsibilities and perform special projects as required or requested.

JOB REQUIREMENTS:

  • High School diploma or GED.
  • Data entry and/or typing experience.
  • Clear and concise written and verbal communication skills.
  • Experience processing medical claims.
  • Ability to multi-task and prioritize.

This is not a local branch position. 
Please DO NOT call the local branch, if interested respond to this posting and attach your resume.

Apply Now!  Please contact  Dawnielle, Commercial Recruiter with Kelly, IMMEDIATELY.

Email resume:  Dawnielle.jackson@kellyservices.com

If not interested in the positions or know someone who is, please contact Dawnielle Jackson directly at dawnielle.jackson@kellyservices.com.

 

Why Kelly®?

As a worker today, it’s up to you to take charge of your career and look for opportunities to learn, grow, and achieve your potential. Helping you find what’s next is what we’re all about. We know what’s going on in the evolving world of work—just ask the nearly 500,000 people we employ each year. Connecting with us means getting the support, guidance, and opportunities needed to take your career where you may have never imagined.

About Kelly®

At Kelly, we’re always thinking about what’s next and advising job seekers on new ways of working to reach their full potential. In fact, we’re a leading advocate for temporary/nontraditional workstyles, because we believe they allow flexibility and tremendous growth opportunities that enable a better way to work and live. Connecting great people with great companies is what we do best, and our employment opportunities span a wide variety of workstyles, skill levels, and industries around the world.

Kelly is an equal opportunity employer committed to employing a diverse workforce, including, but not limited to, minorities, females, individuals with disabilities, protected veterans, sexual orientation, gender identity. Equal Employment Opportunity is The Law.
#KellyGTS

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