Claims Clerical Support

The Under 65 Claims Clerical Support Unit is responsible for entering and processing claims, ensuring timely turnaround (1-2 days), and reviewing claim submissions for discrepancies. Individuals on the team are flexible with their work and manage their time accordingly based on work needs.Duties And ResponsibilitiesEnter claim details into the processing system (such as claim number, policy number, total charge, service date, provider, patient, etc.) to prepare claims for review by the claims examinersIdentify and report discrepancies in claims (e.g., incorrect patient names, birthdates, etc.)Maintain a 1-2 day turnaround time from claim receipt to claim managementReview and log claims/documents submitted through the Policyholder Portal, Agent Portal, and any other referred portals within the companyReport any discrepancies or issues with claim submissions to leadershipCommunicate any issues related to the portals to leadershipEnsure claims are processed as quickly as possible, aiming for a one-day turnaround timeSort and distribute incoming mail within the U65 claims departmentHandle returned mail efficientlyIn certain situations, make copies of received information and forward the mail to the appropriate department for further processingReview and resolve claims in the SDS Eligibility Queue, which contains claims that the clearinghouse cannot match to the eligibility file (due to mismatched policy numbers, names, birthdates, or addresses)Claims must be matched or closed if they cannot be verified Review and manage claims in the SDS Pended Rejected Queue, where claims are placed if they are incomplete or illegible (missing diagnosis codes, CPT codes, provider info, etc.)Missing information should be added, or the claim should be closed, with a letter sent to the provider requesting the necessary detailsEnsure that all queues are maintained with a 1-2 day turnaround timeInform leadership of any unusual or complex cases/issues within the queues for appropriate handling instructionsQualifications And Skills RequiredExcellent communications skills (Both verbal and written)Basic Word and Excel skillsAble to prioritize duties and effectively manage timeAbility to be flexible when needed, take initiative, and demonstrate accountabilityAbility to work well within a team environment and participate in department/team projectsMust be customer service oriented High School or GEDLegal rights to work in the USPreferredProficiency in Microsoft Office productsEqual Opportunity EmployerNew Era Life Insurance is an Equal Opportunity employer that strives to provide and maintain a work environment that fosters mutual respect, professionalism and cooperation. All qualified applicants will receive consideration for employment without regard to actual or perceived race, creed, color, religion, national origin, ancestry, alienage or citizenship status, age, disability or handicap, sex, gender identity, marital status, familial status, veteran status, sexual orientation or any other characteristic protected by applicable federal, state or local laws.