Hospital Claims Processor I

Claims Processor II
Our purpose, to improve customers' lives by making healthcare work better, is far from ordinary. Working at Premera means you have the opportunity to drive real change by transforming healthcare.
By investing in our employees and fostering a culture of collaboration and continuous development, we're able to better serve our customers. Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog.
The Claims Processor II is responsible for the accurate and timely review, research, and resolution of moderately complex claims in accordance with contracts and policies. This may include subrogation, Medicare, and coordination of benefits for dental, medical and hospital claims. Incumbent is responsible for interpreting procedures and policies to ensure accurate claims resolution. Incumbent may also be responsible for processing simple and routine claims.
Review, process, and resolve moderately complex claims in accordance with contracts and policies.
Research claims through the utilization of reference materials and on-line tools.
Responsible for accurately coding claims through the system.
Translate data into information acceptable to the claims processing system including follow up on pending claims.
Maintain all appropriate claims files and perform follow-up on pending claims.
Prepare claims for return to Provider or Subscriber when additional information is needed.
Maintain confidentiality of all documents/files.
May provide `buddy training' and feedback to new associates.
Apply commitment to quality by doing things right the first time to avoid defects from reaching customers or requiring internal re-work.
High School diploma or GED. (Six (6) months claims processing experience or customer service experience. (Technical experience of contract benefits, claims processing steps, and correction procedures. (Stronger claims processing and research skills.
Knowledge of contracts, benefits, and claim procedures.
Experience resolving moderately complex claims.
Greater accuracy, productivity, and quality expertise.
Physical Requirements: The following have been identified as essential physical requirements of this job and must be performed with or without an accommodation: This role requires the ability to keyboard and to communicate clearly and understandably in person, and over the telephone.
Our comprehensive total rewards package provides support, resources, and opportunities to help employees thrive and grow. Our total rewards are more than a collection of perks, they're a reflection of our commitment to your health and well-being. We offer a broad array of rewards including physical, financial, emotional, and community benefits, including:

Medical, vision, and dental coverage with low employee premiums.
Life and disability insurance.
Retirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service.
We have tuition assistance for both undergraduate and graduate degrees.
For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement.

Free convenient on-site parking.
Participate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more.
Our complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling.
Challenge someone to a game of shuffleboard or ping pong while on campus.
Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.
If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at View email address on click.appcast.io or via phone at View phone number on click.appcast.io.
we generally target up to and around the midpoint of the range.