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CareSource

Claims Specialist III

CareSource, Myrtle Point, Oregon, United States, 97458

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Employer Industry: Healthcare Services

Why consider this job opportunity

Salary up to $64,700.00

Opportunity for bonuses tied to company and individual performance

Comprehensive total rewards package focused on employee well-being

Supportive work environment that fosters collaboration and professional growth

Chance to make a significant impact on healthcare operations and claims processes

What to Expect (Job Responsibilities)

Resolve complex coordination of benefits (COB) issues through member information updates and claim adjustments

Process and adjust a wide variety of claims accurately and timely, adhering to established guidelines

Act as a technical resource for training and coaching team members

Identify, track, and trend claims payment errors to determine root causes and corrective actions

Ensure compliance with regulatory and accreditation standards in reporting provider inquiries and complaints

What is Required (Qualifications)

High School Diploma or equivalent

Minimum of one (1) year of experience in a claims environment or related healthcare operations

Proficient in Microsoft Office Suite, including Word, Excel, and PowerPoint

Strong written and verbal communication skills

Knowledge of medical terminology, CPT, and ICD coding is strongly preferred

How to Stand Out (Preferred Qualifications)

Previous experience in an HMO or related industry

Previous Medicare/Medicaid dual eligible claims experience

Experience in a Managed Care Organization or related healthcare industry

Intermediate level data entry skills

Strong problem-solving skills with attention to detail

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