Adjustment Specialist

Position Code: 346

Department:  Recoveries/Adjustments
Location: Little Rock, Arkansas
Immediate Supervisor:  Marie Canada
Status: Non-Exempt
Posted: July 07 2017

Essential Functions of Job:

• Processing and evaluating medical and dental claims • Researching previous claims processing and auditing patient’s claims history • Prioritization of individual work flow associated with the case assignments • Establishing and maintaining professional rapport with clients and providers (physicians and hospitals) • Maintaining and assuring accuracy of documentation • Discuss with members, clients and providers the issues relating to claim administration • Ability to report to the office

Qualifications:

• High school diploma or equivalent • Effective organizational and prioritization skills • Excellent oral and written communication skills • Basic knowledge of Microsoft Office software applications (Word, Excel, Outlook, Access) • Ability to work in a fast paced multi-tasking environment • Strong interpersonal skills with ability to function as a positive team member • Superior skills in benefits interpretation • Strong mathematical background • Ability to analyze and solve complex claims issues and adjustments • 3-5 years experience in processing medical, dental and/or vision claims preferred

 

The Company considers applicants without regard to race, color, national origin, sex, religion, mental or physical disability, marital status, age 40 years and over, sexual orientation or gender identity, veteran's status, or other characteristic protected by applicable law.

Applications for this vacancy will be received for 3 working days after the Posted date from Employees of HealthSCOPE Benefits with more than one year of service.

Applications for this vacancy will be received for 10 working days after the Posted date from External Applicants.