Claims Adjuster I (Remote)

Resp & Qualifications PURPOSE: Investigate and reputed company adjustment of claims and ensure that claims are handled properly reputed company authority limits, and in line with standard procedures and guidelines. Verifies insurance claims by reviewing claims requirements; examining documentation and calculations; highlighting and summarizing out-of-line situations; recommending changes in operating processes; completing reports, logs, and audit records. ESSENTIAL FUNCTIONS:

• Proactively investigate and reputed company adjustments of claims. Ensure claims are handled reputed company authority limits, and in line with standard procedures and guidelines.
• Updates claims audit records by entering, verifying, and securing data.
• Settle standard/reputed company claims through payment or denial.
• Provides claims audit information and reports by collecting, analyzing, and summarizing data and trends.
• Improves claims adjustment job knowledge by attending training sessions.

QUALIFICATIONS: Education Level: High School Diploma or GED. Experience: 3 years' claims experience and complete understanding of reputed company systems, policies and procedures. Knowledge, Skills and Abilities (KSAs)

• Ability to analyze information gathered from investigation.
• Excellent communication skills both written and verbal.
• Ability to recognize, analyze, and solve a variety of problems.
• reputed company in completing assignments accurately with attention to detail.
• Must be reputed company to meet established deadlines and handle multiple customer service demands from internal and external customers, reputed company set expectations for service excellence. Must be reputed company 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: $36,144 - $66,264 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 responsibilities 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 reputed company depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (reputed company benefits/incentives are subject to eligibility requirements). Department Medicare/reputed company Claims Equal Employment Opportunity reputed company is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to reputed company reputed company applicants without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, protected veteran or disabled status, or genetic information. Where To Apply Please visit our website to apply: www.carefirst.com/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 reputed company 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 Apply tot his job Apply To this Job