Top 2 Claims processor Jobs in Troy, Mi

Claims Processor
MICHIGAN CONFERENCE OF TEAMSTERS WELFARE FUND —Detroit, MI
- Full-time
- Hybrid work
- Mid-level
- High school diploma or GED
- EMR systems
- Health insurance
- Dental insurance
Quick Apply
Claims Processor
Michigan Automobile Insurance Placement Facility —Farmington Hills, MI
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Writing skills
- Health insurance
- Dental insurance
Quick Apply

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Claims Processor

MICHIGAN CONFERENCE OF TEAMSTERS WELFARE FUND -
Detroit, MI

Quick Apply

Job Details

Full-time

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance

Qualifications

Insurance claim adjustments processing
Medical claims
Medical collection
Medical coding
Insurance claim appeals processing
Dental insurance
High school diploma or GED
Health insurance knowledge
EMR systems
Insurance claim processing
Quality data entry

Full Job Description

The Michigan Conference of Teamsters Welfare Fund has an immediate availability for a Claims Processor. This is an hourly, unionized position, represented by the Office and Professional Employees Union, Local 42. Essential functions of the position include, but are not limited to:

Process Medical Claims

· Review medical claims submitted electronically to ensure completeness and accuracy.

· Authorize claim for payment or reject payment and update the claim with the appropriate rejection code.

· Place in hold status any claim that requires review or correction.

· Update system to document status of claims sent to Blue Cross Blue Shield (BCBS) for reversal.

Process Dental Claims

· Return to Delta Dental or the provider those claims that cannot be processed by MCTWF staff.

· Update basys system to reflect that a participant and/or dependent is not eligible for coverage of claims for services covered by a work, auto, or third-party claim.

· Notify Benefit Recovery of update for pursuit of overpayment as appropriate.

Process Loss of Time (LOT) claims

· Review each submission for accuracy and updated information.

· Verify eligibility and perform system updates. Notify Benefit Recovery of changes in eligibility for pursuit of overpayment as appropriate.

· Review and update responses in basys to letters requesting additional information Monitor all incoming faxes for distribution to staff. Send claims to the appropriate area for processing.

· Process initial Total and Permanent Disability (TPD) claims in the basys system and maintain related files. Gather all necessary information and documents to process these claims.

· Complete various claim reports, such as 835 errors or open correspondence, on a regular cadence.

Perform other duties as assigned.

The successful candidate will possess the following skills and knowledge:

· High School diploma; Associate degree in related discipline preferred.

· A minimum of 2 years of experience processing medical, dental, and disability claims.

· Exceptional attention to detail.

· Ability to enter data into various electronic systems accurately.

· Familiarity with claims and billing software systems.

The successful candidate must live within a reasonable driving distance from the office located at 2700 Trumbull, Detroit, Michigan

While working a remote assignment, the successful candidate must have access to internet with sufficient speed and stability.

Job Type: Full-time

Benefits:

401(k)
Dental insurance
Health insurance
Paid time off
Vision insurance

Experience:

Claims Processing: 2 years (Required)
Medical, Dental Claims: 2 years (Required)

Ability to Commute:

Detroit, MI 48216 (Required)

Ability to Relocate:

Detroit, MI 48216: Relocate before starting work (Required)

Work Location: Hybrid remote in Detroit, MI 48216

Quick Apply

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