Work From Home Jobs (Remote) In Mundelein @Usaremotejob ( Claim Benefit Specialist )
Hiring Organization: CVS Health
Post Name: Claim Benefit Specialist
Qualification: Graduate
Industry: Private
Employment Type: Full Time
Work Hours: 8 Hours
Salary: $20 – $30/Hour
Location: Illinois, USA
Full Job Description
Review and determine routine Medicare claims in the HRP process according to claims processing guidelines. Claims results must meet/exceed production and quality standards in accordance with CMS and Aetna's compliance and business requirements. Monitors and approves regular claims that cannot be resolved immediately.
Applies medical necessity guidelines, determines coverage, performs eligibility verification, identifies discrepancies and implements all cost containment measures to support the claims process. Requests for evidence or submissions to determine, review or apply appropriate guidelines, coding, member identification procedures, vendor selection procedures, filing, including procedures, diagnostic tests and precoding.
Can support training when considered as a subject matter expert. In accordance with the operational guidelines, manage the declarations in the table, route/route and ECHS within the specified turnaround time (electronic mail processing system - the system used to process mails that are checked by the supplier) 'internal system).
Utilizes all applicable system functions to ensure accurate and timely claims processing
Work From Home Jobs (Remote) In Mundelein @Usaremotejob ( Claim Benefit Specialist )
Note: Our CBS and Medicare levels are not limited to initial claims. These positions may support different Medicare operating systems based on business needs. These can be FE statements, professional services or our business groups.-
Payment amount
The typical cost for this service is as follows:
Minimum: 5:00 p.m.
Range: 27.90
Please note that this range represents the salary for all positions and job classes in which this position falls. The actual salary offer will take into account many factors, including location.
Permission required
- Experience in a manufacturing environment
- Complete with knife driven
- Ability to analyze and work on multiple computer applications simultaneously
- Microsoft Outlook
Eligibility of candidates
- Experience in complaint handling
- Computer navigation skills
- Production and quality conditions
- Microsoft Office applications
Education
- Bachelor's degree or equivalent GED
Work From Home Jobs (Remote) In Mundelein @Usaremotejob ( Claim Benefit Specialist )
