Corporate Plan Management (CPM, Inc)

Posted 1 month ago

Who We Are Looking For:

This position is responsible for accurate and prompt payment of claims, in addition providing customer service. The Claims Analyst is responsible for adjudication of medical and dental claims. The Analyst will be expected to maintain production and quality standards.

The Analyst will also handle customer service calls.  You will be an intricate part of a team that builds long-lasting relationships with our client’s most valuable assets, their employees. Our Customer Service team is one of the main reasons that we are booming in this industry. Our ideal candidate cares deeply, genuinely, and passionately about customer service and the role is plays in making a company successful. Are you ready to become a voice of CPM?

Daily Tasks:

  • Coordinates with the Claims Supervisor on workflow issues and the handling of batches
  • Responsible for maintaining an excellent quality standard and high production standard
  • Evaluates each claim for appropriate coding of CPT and ICD codes against charges that are being billed and entered
  • Responsible for inputting accurate batch accounts, invoice numbers, status codes to ensure accurate entry into Claims Processing system, which creates reporting
  • Takes ownership of the total work process and provides constructive information to minimize problems and increase customer satisfaction
  • Handles customer service calls with the utmost care, compassion and expediency


Required Qualifications:

  • High School Diploma or GED
  • 1 – 3 years of health care claims processing experience
  • Medical Terminology, 10-key and computer literacy
  • Proficient with Medicare processing guidelines, working knowledge of medical contracts, RBRVS, facility and ambulatory payment methodologies
  • Exceptional ability to organize, prioritize and communicate effectively
  • Must have commonly used knowledge of claims examination concepts, practices and rules, ICD and CPT coding and network contracts
  • This position utilizes experience and judgment to plan, accomplish goals, and effectively solve problems
  • Ability to make decisions based on sound knowledge
  • Performs a variety of tasks that may require a limited degree of creativity and latitude

“Nice to Haves”:

  • More than 5 years of related experience
  • Advanced training in claims processes
  • Previous customer service experience

Perks:

  • Health and Dental Insurance and Voluntary Benefits
  • Vacation and Personal Leave
  • Maternity and Paternity Leave
  • Employee Assistance Program (EAP)
  • Employer Retirement Contribution Match

Salary Range:  $30,000-$40,000, depends on experience

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