Location: Baltimore, MD
Company: Carefirst Bluecross Blueshield
policies and procedures. Process product or system-specific claims to ensure timely payments are generated and calculate deductibles and maximums as well as research and resolve pending claims. The Claims Processor also use automated system processes to send pending claims to ensure accurate completion according to medical policy, contracts, policies and procedures allowing timely considerations to be generated using multiple systems.
Does extensive research of procedures. May also apply training materials, emails and medical policy to ensure claims are processed correctly. Utilizes the quality team for assistance on unclear procedures and/or difficult claims and receives coaching from
leadership. Ongoing developmental training to performing daily functions. Completes productivity data daily that is used by leadership to compile performance statistics.
Reports are used by management to plan for scheduling, quality improvement initiatives, workflow design, financial planning, etc. Assists Customer Service Reps by providing feedback and resolving issues and answering basic processing questions. QUALIFICATIONS: Education Level: High School Diploma or GED Experience: 3 years years claims experience required Preferred Qualifications 3 years claims processing, billing or medical terminology experience Knowledge, Skills and Abilities (KSAs) Demonstrated communication skills
both written and verbal. Demonstrated strong analytical skills, Demonstrated knowledge and understanding of claims systems and processes.
Demonstrated reading comprehension of materials provided to adjudicate claims, Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
Salary Range: $33,120 - $60,720 Salary Range Disclaimer The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location.
In addition to your compensation, Care First offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). Department MD Medicaid -CLAIMS Equal Employment Opportunity Care First Blue Cross Blue Shield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, interaction, interactionual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
Where To Apply Please visit our website to apply: /careers Federal Disc/Physical Demand Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. PHYSICAL DEMANDS: The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required.
The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. Sponsorship in US Must be eligible to work in the U. S. without Sponsorship#LI-LY1PDN-9ae7d4fc-835d-4964-8ad6-3caf2eb487db
Insurance jobs refer to a variety of roles within the insurance industry, including positions such as actuaries, underwriters, claims adjusters, insurance agents, and customer service representatives. These jobs are characterized by their focus on evaluating risks, determining policy terms, managing claims, selling insurance products, and providing customer support. Notable features of insurance careers include a blend of analytical and interpersonal skills, opportunities for professional growth, and the importance of staying updated with legal and regulatory changes. Insurance professionals often play a crucial part in helping individuals and businesses mitigate financial risks through tailored insurance solutions.
Insurance jobs refer to a variety of roles within the insurance industry, including positions such as actuaries, underwriters, claims adjusters, insurance agents, and customer service representatives. These jobs are characterized by their focus on evaluating risks, determining policy terms, managing claims, selling insurance products, and providing customer support. Notable features of insurance careers include a blend of analytical and interpersonal skills, opportunities for professional growth, and the importance of staying updated with legal and regulatory changes. Insurance professionals often play a crucial part in helping individuals and businesses mitigate financial risks through tailored insurance solutions.
Insurance jobs refer to a variety of roles within the insurance industry, including positions such as actuaries, underwriters, claims adjusters, insurance agents, and customer service representatives. These jobs are characterized by their focus on evaluating risks, determining policy terms, managing claims, selling insurance products, and providing customer support. Notable features of insurance careers include a blend of analytical and interpersonal skills, opportunities for professional growth, and the importance of staying updated with legal and regulatory changes. Insurance professionals often play a crucial part in helping individuals and businesses mitigate financial risks through tailored insurance solutions.
current and prospective commercial loan customers, spreading financial statements, analyzing industry and economic conditions, completing cash flow analysis, completing full underwriting presentation and performing credit investigations to make recommendations as to the creditworthiness of borrowers and protect the Bank from loss with a focus on the larger relationships.
The incumbent provides the highest quality of service to every customer. Primary Responsibilities: Analyzes the creditworthiness of borrowers, identifies key credit issues and prepares full written analysis according to available information and established policies and procedures accurately and timely including completion
of FOCUS underwriting document and all components thereof with the focus on larger relationships and the most complex transactions with little or some oversite.
Prepares cash flow and global cash flow analysis for borrowers according to established policies and procedures accurately and timely to aid in the analysis of a borrower's creditworthiness. Utilizes Baker Hill software to spread various types of submitted financial statements according to established policies and procedures accurately and timely to aid in the analysis of a borrower's creditworthiness. Researches available data including internet sources and subscription-based utilities as available and summarizes information
regarding current and projected status of certain industries and borrowers of Bank services along with general economic trends and conditions according to the availability of research data to aid in the quality of lending decisions.
Develops a personal program for maintaining an adequate level of knowledge in banking matters, compliance, credit analysis, policies and procedures and personal skills and demonstrates interpersonal behavior, attitude, judgment, communication and initiative with customers and employees to ensure an acceptable degree of performance. Acts as effective leader on complex transactions including syndications, multi-level capital structures, and/or investment real estate while demonstrating excellent communication skills and uses those communication skills to voice opinion in a clear, concise manner to effectively solve problems/make recommendations regarding credit structure, risk, appropriate risk ratings and policy compliance.
Independently research various industries utilizing available resources and summarizes information regarding current and projected status of certain industries, markets, and borrowers of Bank services along with general economic trends and conditions according to the availability of research data to aid senior leaders when making lending decisions.
Performs other related duties and projects as assigned. All employees have the responsibility and the accountability to serve as risk managers for their businesses by understanding, reporting, responding to, managing and monitoring the risk they encounter daily as required by F. N. B. Corporation's risk management program. F. N. B. Corporation is committed to achieving superior levels of compliance by adhering to regulatory laws and guidelines. Compliance with regulatory laws and company procedures is a required component of all position descriptions.
Minimum Level of Education Required to Perform the Primary Responsibilities of this Position: BA or BS Minimum # of Years of Job Related Experience Required to Perform the Primary Responsibilities of this Position: 5 Skills Required to Perform the Primary Responsibilities of this Position: Excellent project management skills Excellent communication skills, both written and verbal Excellent organizational, analytical and interpersonal skills Excellent customer service skills Ability to use a personal computer and job-related software MS Word - Basic Level MS Excel - Intermediate Level MS Power Point - Basic Level Knowledge of accounting, tax laws, bank policies, procedures and government regulations.
Licensures/Certifications Required to Perform the Primary Responsibilities of this Position: N/A Physical Requirements or Work Conditions Beyond Traditional Office Work: N/AFor more details: jobs-search. org/finance_baltimore-c434177/commercial-credit-underwriter-investment-real-estate-baltimore_i1971595496
