Claims Coordinator

Claim Coordinator

The Coord must be competent in all functions of a Claim Coord, Assoc and Coord, Claims in addition to more complex claim and issue resolution. Examples of complex claims may include: secondary claim coordination; customer inquiries; claims adjustments. This position is production and quality based and the Coord will be expected to achieve monthly measures.

Essential Functions

• Process claims through on-line adjudication. May include HMO, ASO, PPO, LFO POS, or GP. Processing will include complex claims such as secondary claim coordination, customer inquiries, claim adjustments and complex issue resolution.
• Utilize Lens Inquiry Tracking system to initiate and resolve claim related issues.
• Detailed knowledge of operational/technical functions and software.
• Ability to perform tasks in a high stress environment.
• Ability to complete multiple tasks in a timely manner.
• Ability to meet minimum production and quality standards
• Ongoing oral and written communication within teams.
• Assist in special projects as assigned.

Qualifications

Required

• High School Diploma or equivalent
• 2 years of relevant experience in related field

Preferred

• Associate's Degree or equivalent
• 2 years of relevant experience Working knowledge of claim payment process and interdependence with other departments.
• 2 years of relevant experience working in an environment requiring production and quality minimums

About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

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