Note: The job is a remote job and is open to candidates in USA. Healthcare Management Administrators (HMA) is a premier third-party health plan administrator that provides customized health plans to medium to large-size employers. The Claims Specialist II will be responsible for the accurate and timely processing of various claims, ensuring a positive healthcare experience for members while working collaboratively within a dedicated team.
Responsibilities
• Research and process ITS claim adjustments, returned checks, refunds and stop payment in an accurate and timely manner
• Communicate with local Blue plans utilizing real time chat
• Process priority claims and general inquiries
• Respond to appeals and correspondence regarding claims functions
• Support team members and be open to providing assistance when and where needed
• Become a SME regarding BCBS network
Skills
• Experience in processing medical, dental, vision, and short-term disability claims
• Ability to research and process claim adjustments, returned checks, refunds, and stop payments accurately and timely
• Strong communication skills to interact with local Blue plans utilizing real-time chat
• Experience in processing priority claims and general inquiries
• Ability to respond to appeals and correspondence regarding claims functions
• Willingness to support team members and provide assistance when needed
• Ability to become a Subject Matter Expert (SME) regarding BCBS network
Benefits
• Comprehensive salary
• Pay transparency
• Benefits
• Time off package
• Plenty of personal development and growth opportunities
Company Overview
• HMA is Proving What's Possible in Healthcare®. It was founded in 1986, and is headquartered in Bellevue, Washington, USA, with a workforce of 201-500 employees. Its website is https://www.accesshma.com.
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