Claims Representative - Evernorth - Remote
Core
Manually review and process medical, supplemental, or dental claims based on benefits, eligibility, and internal policies.
Role type
Claims Representative
Builds
Processed claims for health insurance plans
Domain
Health Insurance / Claims Processing
Required skills
Medical and insurance terminology, CPT/ICD-10 codes, Microsoft Excel (filtering/sorting), navigating multiple computer applications, applying complex policy/procedure documents
Preferred skills
Health insurance claims processing experience, medical/insurance terminology in professional setting, CPT/ICD-10 codes knowledge
Responsibilities
Research and navigate documents/databases to process claims, confirm presence of necessary documents, validate accuracy of medical codes, assess eligibility status, review other insurance coverage, evaluate authorizations, analyze account benefit plans, identify discrepancies/errors/missing information
Seniority
Entry-level to Junior