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Claims Representative I/II/III

  • Job
    Full-time
    Entry, Junior & Mid Level
  • Customer Relations
    Healthcare
  • Columbus, +2

AI generated summary

  • You need a HS diploma; Claim Rep I: related experience; Claim Rep II: 1+ years in claims processing; Claim Rep III: 3+ years internal claims experience, or equivalent education/experience.
  • You will code and process claims, ensure accuracy, research claims issues, and work under supervision while relying on guidance for technical tasks.

Requirements

  • Minimum Requirements
  • Claim Rep I - Requires HS diploma or equivalent and related experience; or any combination of education and experience which would provide an equivalent background.
  • Claim Rep II - Requires a HS diploma or equivalent and a minimum of 1 year of claims processing experience; previous experience using PC, database system, and related software (word processing, spreadsheets, etc.); or any combination of education and experience which would provide an equivalent background.
  • Claim Rep III - Requires a HS diploma and a minimum of 3 years of the companies internal claims experience; or any combination of education and experience which would provide an equivalent background.

Responsibilities

  • Learning the activities/tasks associated with his/her role. Works under direct supervision.
  • Relies on others for instruction, guidance, and direction.
  • Work is reviewed for technical accuracy and soundness.
  • Codes and processes claims forms for payment ensuring all information is supplied before eligible payments are made.
  • Researches and analyzes claims issues.

FAQs

What is the job title for this position?

The job title is Claims Representative I/II/III.

Where is this position located?

This position operates in a hybrid model, requiring the ideal candidates to live within 50 miles of one of our PulsePoint locations.

What are the main responsibilities of a Claims Representative?

The main responsibilities include coding and processing claims forms for payment, researching and analyzing claims issues, and completing required basic training.

What is the minimum requirement for Claim Representative I?

Claim Representative I requires a high school diploma or equivalent and related experience, or any combination of education and experience that provides an equivalent background.

What additional experience is required for Claim Representative II?

Claim Representative II requires a high school diploma or equivalent and a minimum of 1 year of claims processing experience, along with proficiency in using PC, database systems, and related software.

How many years of experience are necessary for Claim Representative III?

Claim Representative III requires a high school diploma and a minimum of 3 years of the company's internal claims experience.

Are there any pre-employment tests required for this position?

Yes, candidates must pass the appropriate pre-employment test battery.

What kind of benefits does Elevance Health offer?

Elevance Health offers various benefits including merit increases, paid holidays, Paid Time Off, medical, dental, vision, short and long-term disability benefits, 401(k) + match, wellness programs, and more.

Is COVID-19 vaccination required for this position?

Yes, new candidates in certain patient/member-facing roles are required to become vaccinated against COVID-19 unless they provide an acceptable explanation.

Does Elevance Health provide equal employment opportunities?

Yes, Elevance Health is an Equal Employment Opportunity employer and considers all qualified applicants regardless of various protected statuses.

Who should I contact for assistance with the job application process?

Applicants who require accommodations to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

Improving the health of humanity

Science & Healthcare
Industry
10,001+
Employees

Mission & Purpose

Fueled by our bold purpose to improve the health of humanity, we are transforming from a traditional health benefits organization into a lifetime trusted health partner.   Our nearly 100,000 associates serve more than 118 million people, at every stage of health. We address a full range of needs with an integrated whole health approach, powered by industry-leading capabilities and a digital platform for health.  We believe that improving health for everyone is possible. It begins by redefining health, reimagining the health system, and strengthening our communities.