Claims Analyst (6235)

Portland Metro Area, OR | Consulting

Post Date: 05/29/2018 Job ID: JN -052018-6235 Industry: Claims Assistant
Evo is seeking a Claims Analyst for our East Portland client. You will process medical, dental, disability, pharmacy, and flexible spending claims in a timely and accurate manner. You will be the primary contact for groups and members in answering claims questions and resolving issues. This contract opportunity is 6-month contract-to-hire.

DUTIES:
  • Process medical and/or dental claims, as well as disability, pharmacy, flexible spending, or vision claims, if applicable
  • Interpret and apply specific plan document language as well as determine eligibility for benefits during claims adjudication
  • Provide written correspondence and verbal information to members, group contacts, agents, and healthcare providers
  • Refer potential abuse, subrogation and adjustment claims
  • Perform necessary check run process and communicate check register information
  • Provide responsive and professional customer service for assigned groups as well as other groups
SKILLS and REQUIREMENTS:
  • 1-2 years of related experience
  • Maintain a positive and professional attitude
  • Work with members of staff on identifying process improvements
  • Flexibility to work overtime as dictated by department/company needs
  • Thorough understanding of Self-Funding and Third-Party Administrating concepts
  • Demonstrated written and oral communication skills
  • Ability to navigate through and utilize various PC applications efficiently
  • Strong organization skills, problem solving and decision-making skills
  • Self-starter
  • Strong understanding of claims analyst process and procedures
  • Must have coding and medical terminology training
Applicants must be fully authorized to work in the U.S. and physically be in the U.S.
CORP-to-CORP requests will NOT be entertained.
Relocation assistance will not be available for this position.

Evo is an equal opportunity employer and considers qualified applicants for employment without regard to race, gender, age, color, religion, disability, veteran status, sexual orientation, gender identity, or any other protected factor.

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