Claim Validator

Top Job

Located in Utica, NY

Position Summary:

This position is responsible for ensuring that mail and faxes (Claim Forms, HCFA, UB04, Bills, EOBs and miscellaneous submitted documents) are sorted, staged and scanned into ELA View. This position is responsible for ensuring that Claim Information (Claim Forms, HCFA, UB04, Bills, EOBs and miscellaneous submitted documents) are correct and virtually assigned to each assigned examiner. This position is also responsible for ensuring that Miscellaneous Records are efficiently and effectively evaluated and reported to our School Plans Admin System. Determining appropriate template was utilized to ensure transactions are appropriate to flow through EDI Processing to our Admin System. Availability and reliability are key components to this position, requiring and maintaining a full time status.

Required Knowledge, Skills and Abilities:

Work effectively with Supervisor to ensure miscellaneous items are reported timely.

Level of knowledge of products and procedures including an understanding of school, accident & health and special risk insurance.

Ability to coordinate and prioritize workflow.

Must be able to work within a team environment as well as independently.

Ability to present a positive and professional image.

Knowledge of HIPAA Regulations

Observe and comply with Company-established procedure

Associates Degree or equivalent business experience

Excellent keyboarding skills

Insurance experience preferred.

Required Knowledge, Skills and Abilities:

Work effectively with Supervisor to ensure miscellaneous items are reported timely.

Level of knowledge of products and procedures including an understanding of school, accident & health and special risk insurance.

Ability to coordinate and prioritize workflow.

Must be able to work within a team environment as well as independently.

Ability to present a positive and professional image.

Knowledge of HIPAA Regulations

Observe and comply with Company-established procedure

Associates Degree or equivalent business experience

Excellent keyboarding skills

Insurance experience preferred.

Express Office: Utica/Rome
The Landmarc Building
118 Columbia Street, Suite 103
Utica, NY 13502




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