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Regence Claims Service Analyst I

Company: Washington Tacoma
Location: Tacoma
Posted on: October 17, 2020

Job Description:

Overview Regence Claims Service Analyst I Tacoma, WA Class Start Date: October 26, 2020 Minimum starting pay: $14.50; Maximum starting pay $15.50 DOE Role will close: September 25, 2020 by 3pm At Cambia, our values are fundamental to achieving our Cause of transforming the health care industry. They guide our actions and bring diverse perspectives together to improve the health care journey better for those we serve. All eight values are equally important and linked to the others: Empathy, Hope, Courage, Trust, Commitment, Innovation, Collaboration and Accountability. These values are not just words on paper - we live them every day. Responsibilities Bring your curiosity and excellent analytic skills to the Claims Service Analyst role As an Claims Service Analyst, you will investigate and apply contract benefits to submitted claims. You will also: Maintain knowledge of all policies and procedures that apply to claims and be able to quickly reference documentation for details. Make informed decisions regarding the disposition of claim this may include; payment or denial of claim, or requests for further information. Perform at a level meeting production requirements and quality standards Resolve claims issues by applying knowledge of medical terminology, ICD-9, CPT coding and other resources. Provide excellent customer service to customers, providers, members, and member representatives. Identify and report any irregularities or trends in claims processing and/or provider billing. Adapt to changes that affect the job, such as contract changes as well as procedure or system changes to ensure correct processing of claims. Organize, maintain and keep readily accessible, all references, documents, policies and procedures to ensure correct application of contract benefits. Perform work in an orderly fashion and provide clear audit trails for ease of reviewing the overall work involved in a case. Comply with /MTM and Consortium standards as they relate to the employee's responsibility to meet BlueCross BlueShield Association (BCBSA) standards and corporate goals. Contact providers as needed to request additional information. Contribute to the efficiency of department by being flexible and cross-trained on other functions. Key Qualifications and Experience Claims Analyst would have a high school diploma or equivalent and 1 year office experience preferably in health insurance claims or in a medical office setting or equivalent combination of education and experience. Basic knowledge of medical terminology, CPT and ICD-9 coding preferred. Ability to prioritize and organize workload. Basic math skills. Ability to communicate effectively orally and in writing. Ability to work as part of a team as well as independently. Decision making ability. Claims Service Analysts work Monday through Friday between 6:00am - 4:30pm. To show our dedication to employee satisfaction, our generous benefit package starts on your first day. Our leadership team is committed to creating a supportive, fun, and empowering environment where you'll gain skills and experience in an ever-changing health care industry and have a positive effect on your local community. Note: Please check your email (including spam and junk mail folders) during the process for important status updates and information. Qualifications Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A drug screen and background check is required. Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members for 100 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association. If you're seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers' engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions. Information about how Cambia Heath Solutions collects, uses, and discloses information is available in our Privacy Policy. PI123832497 Apply Here

Keywords: Washington Tacoma, Tacoma , Regence Claims Service Analyst I, Professions , Tacoma, Washington

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