Claims Specialist

Franciscan Health Munster Campus 701 Superior Ave Munster, Indiana 46321 WHAT WE NEED Persistent, organized financial support WHO WE ARE LOOKING FOR Some people love getting to the bottom of things – reviewing medical claims, resolving accounts, digging through the details to identify discrepancies and needs. Yes, we’re talking about people who love claims. And it takes a love of getting into the details to do this job well. Do you have top notch customer service and data entry skills? Are you good at following through on inquiries? Are you accurate and organized? We’d love to talk to you about working here.

Process managed care medical claims according to established policies, plan specifications and performance requirements. Analyze claims to determine whether they should be approved or denied payment. Review and address provider inquiries regarding claim adjudication. Provide customer service for plan enrollees, employers and providers by answering questions related to claim status, benefits, payment and appeals. Develop and perform quality assurance activities related to claims processing. WHAT IT TAKES TO SUCCEED Prior managed care medical claims experience. Customer service skills necessary to deal effectively and courteously with all levels of management, employees, and external contacts. Experience and knowledge of ICD10 and CPT coding. TRAVEL IS REQUIRED: Never or Rarely EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.