claims specialist.
earth city , missouri
posted 1 day ago
job details
summary
$30 - $35 per hour
temp to perm
associate degree
category personal care and service occupations
referenceAB_4630006
job details
We are looking for a driven Claims Operations Specialist to join a growing team located in Earth City, MO, 63045. The claims specialist will be responsible for working with internal and external partners to help manage client data. The ideal candidate will have previous experience working with claims, and have great attention to detail. Knowledge of benefit accumulators, eligibility, and data extracts preferred. Please if interested! Pay: $65,000.00 - $75,000.00 Schedule: Monday -Friday , 9:00am - 6:00pm
salary: $30 - $35 per hour
shift: First
work hours: 9 AM - 6 PM
education: Associate
Responsibilities
Conduct quality assurance audits of pharmacy claims, vendor files, and operations tickets
Manage day-to-day process (i.e. audit benefit accumulator files, work daily reject and QA reports)
Troubleshoot and perform research on data integration issues, JIRA tickets, and escalations
Translate business needs and processes into clear and concise documentation
Monitor client implementation activities, identify, and escalate any at-risk milestones
Support the reporting needs of the department
Manage member and pharmacy related requests via Jira and resolve within the agreed upon Service Levels
Skills
Claims Processing
Claims
Medical Claims
Basic Software Skills
Verbal Communication
Written Communication
Analytical Thinking
audit
Qualifications
Years of experience: 1 year
Experience level: Experienced
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Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including health, an incentive and recognition program, and 401K contribution (all benefits are based on eligibility).
This posting is open for thirty (30) days.
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