Claims Clerk reviews insurance claim forms and supporting documents for completeness and accuracy and obtains missing information as necessary. Inputs claim information into system for processing. Being a Claims Clerk verifies coverage eligibility. Calculates settlement amounts according to guidelines. Additionally, Claims Clerk processes routine claim payments. Requires a high school diploma or equivalent. Typically reports to a supervisor. The Claims Clerk works under the close direction of senior personnel in the functional area. Possesses a moderate understanding of general aspects of the job. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)
Brookings Health System is seeking a Claims Specialist to join our team and be part of the Brookings Health System mission: To provide high quality, compassionate, personalized health care.
This full-time, benefit eligible position will be expected to process third party insurance including commercial insurance, Medicare, Medicaid or government-assisted programs & will be expected to comply with all regulatory bodies and agencies. Some of the duties include submitting claims, ensuring compliance with internal and external customers via verbal and written communication, processing payments, performing follow-up on claims when necessary, and appealing claims when denied or downgraded.
Qualifications: