Summa Health System
Sr Claims Processor
Summa Health System, Akron, Ohio, United States, 44329
Sr Claims Processor
SummaCare - 1200 E Market St, Akron, OH
Full-Time / 40 Hours / Days
Summa Health System is recognized as one of the region's top employers by a number of third party organizations, including NorthCoast 99. Exceptional candidates gravitate to Summa because of its culture, passion for delivering excellent service to our patients and families commitment to our philosophy of servant leadership, collegial working relationships at every level of the organization and competitive pay and benefits.
Summary :
Responsible for the accurate and timely processing of claims per regulatory and contractual guidelines. Reviews claims involving coordination of benefits, medical coding and authorization assignments and sub-system updates. Utilizes understanding and application of cost containment techniques when vendor partnerships are utilized to reduce overall cost of claims while applying plan or line of business specific processing rules. This would include but not be limited to repricing reconciliation and case agreement claim processing. May include some mentoring of junior processors.
Formal Education Required:-High School Diploma or equivalent
Experience & Training Required :-Two (2) years experience in health insurance claims processing, health claims data entry including Document Management Services (DMS), customer service experience in a managed care environment, physician or hospital billing, and/or patient accounts
Other Skills, Competencies and Qualifications:-Word and Excel and Access at a basic level. Must achieve passing score on test administered by Human Resources.-MS-windows based computer environment-Skilled in medical terminology, CPT, HCPCs and ICD-10 coding-Understanding of professional (CMS1500) and institutional (UB-04) claim types-Health claims processing knowledge-Close attention to detail with independent judgment, decision making and problem solving skills-Independent judgment and decision-making skills
Level of Physical Demands:-Sit for prolonged periods of time-Bend, stop and stretch-Lift up to 20 pounds-Manual dexterity to operate computer, phone and standard office machines
$20.31/hr - $24.37/hr
The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.
SummaCare - 1200 E Market St, Akron, OH
Full-Time / 40 Hours / Days
Summa Health System is recognized as one of the region's top employers by a number of third party organizations, including NorthCoast 99. Exceptional candidates gravitate to Summa because of its culture, passion for delivering excellent service to our patients and families commitment to our philosophy of servant leadership, collegial working relationships at every level of the organization and competitive pay and benefits.
Summary :
Responsible for the accurate and timely processing of claims per regulatory and contractual guidelines. Reviews claims involving coordination of benefits, medical coding and authorization assignments and sub-system updates. Utilizes understanding and application of cost containment techniques when vendor partnerships are utilized to reduce overall cost of claims while applying plan or line of business specific processing rules. This would include but not be limited to repricing reconciliation and case agreement claim processing. May include some mentoring of junior processors.
Formal Education Required:-High School Diploma or equivalent
Experience & Training Required :-Two (2) years experience in health insurance claims processing, health claims data entry including Document Management Services (DMS), customer service experience in a managed care environment, physician or hospital billing, and/or patient accounts
Other Skills, Competencies and Qualifications:-Word and Excel and Access at a basic level. Must achieve passing score on test administered by Human Resources.-MS-windows based computer environment-Skilled in medical terminology, CPT, HCPCs and ICD-10 coding-Understanding of professional (CMS1500) and institutional (UB-04) claim types-Health claims processing knowledge-Close attention to detail with independent judgment, decision making and problem solving skills-Independent judgment and decision-making skills
Level of Physical Demands:-Sit for prolonged periods of time-Bend, stop and stretch-Lift up to 20 pounds-Manual dexterity to operate computer, phone and standard office machines
$20.31/hr - $24.37/hr
The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.