Claims Clerk I

Job Description

Job Description

Quality Health Management (QHM)is a cost containment company founded in 2000. QHM specializes in reducing the cost of medical expenses, offering provider network access in over 80 countries and providing customized patient assistance primarily for international patients seeking care in the U.S. as well as patients seeking care globally outside of their country of origin. We are currently recruiting for a Claims Clerk. 

Responsibilities

• Answer, screen and transfer inbound phone calls
• Provide general claims support by completing outgoing/incoming requests for additional claim supporting documentation (medical records, itemized bills, corrected claims etc.)
• Conduct data entry and re-work; analyzes and identifies trends and provides reports as necessary.
• Work claims files to ensure the appropriate eligibility and provider records are matched
• Updates and maintains database as requested
• Scan, rename and attach documents
• Assist on different projects as instructed

Qualifications and Skills

• High School or equivalent
• 1+ years of experience in customer service
• Excellent attention to detail and accuracy
• Familiarity with insurance and medical terminology
• Strong communication and interpersonal skills
• Ability to work independently and as part of a team

Quality Health Management (QHM) is a cost containment company founded in 2000. QHM specializes in reducing the cost of medical expenses, offering provider network access in over 80 countries and providing customized patient assistance primarily for international patients seeking care in the U.S. as well as patients seeking care globally outside of their country of origin.

QHM delivers highly personalized health management on each and every case. Our service includes:

Extensive worldwide network of providers
Efficient claims service and custom claims re-pricing
Experienced medical case management
Superior account management and 24 hour member service
Specialty care services including solid organ/bone marrow transplantation, oncology risk management and pharmacy benefits

Company Description

Quality Health Management (QHM) is a cost containment company founded in 2000. QHM specializes in reducing the cost of medical expenses, offering provider network access in over 80 countries and providing customized patient assistance primarily for international patients seeking care in the U.S. as well as patients seeking care globally outside of their country of origin.\r\n\r\nQHM delivers highly personalized health management on each and every case. Our service includes:\r\n\r\nExtensive worldwide network of providers\r\nEfficient claims service and custom claims re-pricing\r\nExperienced medical case management\r\nSuperior account management and 24 hour member service\r\nSpecialty care services including solid organ/bone marrow transplantation, oncology risk management and pharmacy benefits