Overview
TITAN Insurance Administrators Inc. is a progressive third-party administrator of union health and welfare benefits, seeking an individual with a proven ability to multitask in a fast-paced environment. The individual must be dedicated, goal oriented, energetic, efficient and possess a strong work ethic. Bilingual Spanish skills are a plus.
We pride ourselves on our ability to adjudicate claims accurately and timely,
Claims Examiner – Job Description:
The candidate must be able to adjudicate medical, dental, disability and life insurance claims for active and retired Taft-Hartley Trust Fund participants in accordance with the benefit schedule and internal procedures. The candidate must also have the ability to process claims on-line timely and accurately, possess working knowledge of claims codes and descriptions, medical terminology, PPO provider adjudicating guidelines, Coordination of Benefits (COB), eligibility, limitations, exclusions, case management and medical review. Claims will be adjudicated using BASYS software in conjunction with the Anthem Blue Cross PPO claims system. This position requires a minimum of two (2) years of prior claims adjudicating experience.
Please note that this is a full-time position with union wages ($35-$38 per hour) and benefits.
Out of state applicants with extensive and current experience adjudicating claims using the Anthem Blue Cross System are welcome to apply.
Essential Job Functions :
The essential job functions include, but are not limited to the following:
1.Basic knowledge and understanding of group benefit plans.
2.Develop knowledge and understanding of TITAN’s (BASYS software) and Anthem Blue Cross PPO claims systems (WGS and B2).
3. Accurately interpret plan benefits and process claims accordingly.
4.Develop knowledge and understanding of PPO guidelines and procedures, COB, Medicare and supplemental plan benefits.
5.Customer Service Representative responsibilities answering eligibility and benefit questions, providing concise and accurate information, with a written synopsis of each call.
6.Communicate with providers and participants by phone, correspondence/email, faxes or in person.
7. Assist Auditors, Managers and other miscellaneous duties as assigned.
Requirements:
1.Minimum of two (2) years’ experience adjudicating medical, dental, disability and life insurance claims online.
2.Strong knowledge of medical terminology, standard coding and reference publications, including CPT, ICD-10, CMS Guidelines (HCPCS), HIPAA regulations and Health Care Reform requirements,
3.Ability to recalculate claims, performing (sometimes complex) calculations, applying formulas using multiplication and percentages.
4.Outstanding analytical skills, problem solving abilities, and organizational skills.
5.Ability to meet benchmark production requirements while maintaining high quality standards working individually and as a team contributor.
6.Excellent written and verbal communication skills.
7.Attention to detail and the ability to multi-task and work under pressure.
8.Ability to sit for extended periods of time, reach outward or above the shoulder, stand, walk, handle with fingers, stand, bend, and stoop.
9.Ability to operate a keyboard, view a video display terminal screen and documents, ability to use telephone equipment.
10.Ability to lift up to 10 pounds and push or pull up to 12 pounds.
To Apply:
TITAN Insurance Administrators, Inc. is an equal opportunity employer.
...Kelly is seeking a field service technician that would service a solar site in Andrews, TX Position is a long term contract role (... ..., maintenance, warranty remediation and commissioning for installed photovoltaic inverters, energy storage, plant controls, DC, panels...
...Executive Chef - Snoqualmie, WA- Up to $140k Our client is a distinguished private golf club celebrated for its championship course and outstanding member experiences. This is an excellent opportunity to join a team and a company committed to providing its employees...
...Job Title: Document Imaging Specialist Contract Duration: 3+ Months Work Location: Onsite Only (Remote work not permitted) Position Overview: We are seeking a highly organized and detail-oriented Document Imaging Specialist to support a large-scale records...
...Supervisor for our manufacturing facility in Union City, OK. Red River Brick is a subsidiary... ...by being developed to move into higher levels of leadership. Responsibilities Will... ...) and robotics a plus. This is an entry level leadership position with...
...Williamsburg Lodge offers a relaxing retreat, in our newly renovated rooms just steps away from all the action. About the job As a Culinary Intern participant at the Williamsburg Lodge, you work closely with our leadership team, developing key skills and core competencies...