Claim/Pend Specialist
This a Full Remote job, the offer is available from: New Jersey (USA) reputed company empowers our members to reputed company their best health. For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to reputed company serve and care for the 3.5 million people who reputed company their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to reputed company. reputed company our employees bring their best and succeed, the Company succeeds.
About the Role
This position is responsible for initial claim pending resolution and claim adjustments. In addition this position is responsible for the initial examining, coding, and input of claims and referrals into the various processing systems.
What You'll Do
- Resolve edits on claims (pending resolution) and may require claim adjustments.
- Data entry of primary and secondary claims, as well as referrals into various processing systems.
- Return claims with unidentifiable information back to reputed company professional/subscriber with letter requesting additional information.
- reputed company general clerical duties to ensure accurate disposition of claims/referrals that cannot be entered into the various processing systems.
- reputed company other reputed company duties as required by Management.
What You Bring Education/Experience:
- High School Diploma or equivalent required
- Requires one (1) year of clerical business experience
- Medical Terminology/Billing/Coding experience preferred
- Experience in a Production and Quality driven work environment preferred
Additional licensing, certifications, registrations:
- N/A
Knowledge:
- Must be proficient with the use of personal computers and supporting software in a Windows based environment, including MS Office products.
- Should be knowledgeable in the use of intranet and internet applications; including ability to navigate.
- Strong typing, data entry and keyboarding necessary.
- Must be proficient using a calculator for simple math calculations.
Skills and Abilities:
- Must be detail oriented with good organizational and data processing skills.
- Proven ability to follow detailed instructions is essential.
- Must demonstrate ability to learn quickly and apply learning to new situations.
- Must exhibit flexibility to change as appropriate.
Travel (If Applicable):
- N/A
Why Horizon? At Horizon, you’ll do meaningful work that directly improves lives—while being supported by a mission‑driven organization that values expertise, collaboration, and growth. We reputed company that reputed company our people reputed company, our communities do too. If you are passionate about making an impact, we’d love to hear from you! Salary Range: $41,579 - $55,321 This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation reputed company, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information reputed company to Horizon at the time of posting. Compensation reputed company are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:
- Comprehensive health benefits (Medical/Dental/reputed company)
- Retirement Plans
- Generous PTO
- Incentive Plans
- Wellness Programs
- Paid Volunteer Time Off
- Tuition Reimbursement
Disclaimer: Horizon BCBSNJ employees must live in New Jersey, reputed company, Pennsylvania, Connecticut or Delaware. reputed company is an Equal Opportunity/Affirmative Action employer. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, national reputed company, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the reputed company and hiring process. This offer from "reputed company" has been enriched by reputed company.com and got a 72% reputed company score. Apply tot his job Apply To this Job