Claims Processor Associate Job:
Blue Cross and Blue Shield of Minnesota

19581-en_US
Blue Cross and Blue Shield of Minnesota
Virginia Minnesota
Healthcare
Description

 



About Blue Cross



Founded in 1933, Blue Cross and Blue Shield of Minnesota is the largest health plan in the state. We have more members, the largest network of providers and more products and services than any other plan in Minnesota. From the beginning, Blue Cross has been an innovator with a mission of making a healthy difference in people’s lives.



We understand the importance of finding a job that you truly enjoy — at a company that shares your values. We’ve made it easy to feel good about working at Blue Cross by encouraging volunteerism, valuing diversity and offering the flexibility you need to live a balanced life. We offer a suite of comprehensive medical and dental benefits as well as competitive pay, flexible work schedules and generous personal paid time off in addition to 20 hours of volunteer paid time off each year. We look forward to serving Minnesotans over the next 80 years and beyond. Join us and make a healthy difference through the work you do every day.


Description Summary

This position is responsible for entering claim demographics and up front information needed to process a claim. This position is also responsible for working of reports that identify if more research is necessary. Performs clerical office work such as document processing, record keeping, and report compilation requiring independent analysis, exercise of judgement, and a detailed knowledge of department procedures related to work performed.

Accountabilities


  1. Initiate or receive telephone and/or written responses to request for missing or additional information to correctly process claims and update records. Review the claim to ensure proper information is on the claim to complete processing.

  2. Verifies and/or obtains and documents information in order to correctly process claims and update records.

  3. Determines primacy, student dependent status or appropriate action from information that is gathered.

  4. Updates claims/membership system with appropriate information.

  5. Researches history for pended and/or rejected claims and prepares claims to be adjusted, if appropriate.

  6. Requests medical records, if necessary.

  7. Research and resolve frontend system edits and document any additional information or specific action taken using the proper system.

  8. Monitors and works reports.


Requirements


  • High school diploma required.

  • Research and analytical skills required.


Preferred Requirements

FLSA Status

Non-Exempt

Blue Cross Blue Shield of Minnesota is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



 



Make a difference



Thank you for your interest in Blue Cross. Be part of a company that lets you be you — and make a healthy difference in people’s lives every day



Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association

Basic Qualifications
Requirement