Claims Processing Specialist / Claims Remediation Clerk

TEKsystems
$21.00 - $25.00 / hr
dental insurance, life insurance, sick time, short term disability, long term disability, 401(k), retirement plan
United States, Texas, Amarillo
Jan 11, 2025
On-site located in Amarillo, Texas from 8am to 5pm. Potential to work a hybrid schedule after training, two days from home and three in office. Description Under supervision, this position is responsible for examining and processing all claim types including short term or long term disability, life, waiver of premium, critical illness, accident insurance and other claim type for various policies. May perform a variety of related duties or travel to client sites to discuss / resolve claim issues. Job Responsibilities: * These positions involve navigating through multiple computer screens/programs to investigate and verify Dental Insurance coverage and data entry of pertinent claims information. * Input required claim information into system for payment, according to established guidelines. * Contact internal resources to resolve errors and contact providers for missing information. * Process electronic claims (EMC). Top Skills Details * medical claims * processing * data entry * hospital billing * Epic Additional Skills & Qualifications Must have experience with adjudicating Accidental, Critical, Hospital or Short term Disability claims Required Job Qualifications: * Bachelor degree or 4 years of business experience. * 2 years of claims experience. * Proficient in the following: Correspondence, Medical Records Review, Misrepresentation Investigation, Pre-Existing Investigation, Evidence of Insurability Review, Benefit Entitlement Review, Financial Accuracy, ERISA Guidelines, MAR Requirements, State Regulations, Contract Language, Company Financial Liability. * Experience in the following core systems: ECM, STAR (Claim System), Genelco/GIAS, Siebel, UTS, Casetrak, Docsql, Benefits Manager, and ImagePlus. * Experience processing one (1) of the following claim types: Life or Waiver of Premium claims. * Experience in processing any of the following two (2) claim types: Critical Illness/Specified Disease, Accidental Insurance, GAP, Permanent and Total Disability (PTD benefits, Accidental Death and Dismemberment, Permanent and Total Disability (PTD), Accelerated Death Benefits. Pay and Benefits The pay range for this position is $21.00 - $25.00 Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a hybrid position in Amarillo,TX. Application Deadline This position will be accepting applications until Jan 25, 2025. About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.