Interview Studio

Requirements found

Compliance (must) Editing Inventory Microsoft Office (nice) Recruiting (nice)

What this posting asks for

Level: Not stated — The posting does not state a level or years of experience.

Main responsibilities

• Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from…
• Pay Transparency: The base pay for this role is: $20 an hour. You are also eligible for employee benefits, monthly vacation accrual at a rate of 15 days per …
• Responsible for the accurate and timely processing of claims
• Research and processes claims according to business regulation, internal standards and processing guidelines
• Resolves system edits, audits and claims errors through research and use of approved references and investigative sources
• Contribute to the reduction of the daily inventory through processing claims.
• Contribute to team-wide goals that support the success of Claims Productions daily operations.
• Compliance with all applicable laws and regulations
• Other duties as assigned

Competencies an interviewer will look for

• Problem solving Core
  In the posting: “The role works to resolve claim inquiries, provide clarification on claim status, and support prompt reimbursement.” · “Resolves system edits, audits and claims errors through research and use of approved references and investigative sources” · “Ability to solve problems within pre-defined methods and guidelines.”
  Show it by: Describes a real problem, the options considered and the one chosen; Shows how the cause was found, not just the fix.
• Data and analysis Core
  In the posting: “High School Diploma, GED or equivalent years of experience in data analytics, provider data and/or claims processing” · “Ability to review claims and analyze critical data.” · “Experience manipulating and entering accurate data in a production driven environment.”
  Show it by: Uses a number to describe the situation or the result; Explains what the data showed and what was done with it.
• Attention to detail and quality Core
  In the posting: “The Claims Processor 1 is responsible for accurately reviewing, processing, and adjudicating health insurance claims in compliance with company policies, con…” · “This role ensures timely and accurate claim resolution by verifying eligibility, benefits, and supporting documentation;” · “Responsible for the accurate and timely processing of claims”
  Show it by: Gives an example of an error caught before it caused harm; Names the check or standard they used.
• Communication Core
  In the posting: “This role ensures timely and accurate claim resolution by verifying eligibility, benefits, and supporting documentation;” · “Strong verbal and written communication skills.”
  Show it by: Adapts the message to the listener; Gives an example of explaining something clearly in writing or speech.
• Planning and organisation Core
  In the posting: “Demonstrated capacity to balance competing priorities and continue to execute projects with excellence.” · “Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) …”
  Show it by: Shows how priorities were set when everything was urgent; Mentions deadlines met and how.
• Technical skill Supporting
  In the posting: “applying appropriate coding and payment guidelines;”
  Show it by: Names the tools, languages or systems used and how; Explains a technical choice and its trade-off.

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