Associate Claims Representative

This is a fully remote position, open to applicants in North Dakota, +2 more states.

📋 Description

• Accountable for handling health insurance claims submitted either through paper or electronically by providers and members.

• Confirms health insurance claims while having a comprehensive understanding of health insurance cost sharing, limitations, and exclusions.

• Evaluates claims for completeness and correctness.

• Processes health insurance claims for payment in accordance with established workflows.

• Manages assigned pend and error reports.

• Assesses benefit levels to be disbursed based on the summary plan language.

• Provides timely responses to information requests from other departments within Sanford Health Plan.

• Refers complex claims to Senior and/or Lead Claims Representatives.

⛳️ Requirements

• High school diploma or equivalent is mandatory.

• Some college coursework is preferred.

• A minimum of one year of relevant experience is required.

• At least one year of experience in medical claims processing is preferred.

• Basic proficiency in Microsoft Office is required.

🏝️ Benefits

• Health insurance.

• Retirement plans.