Aug 20, 2019
WellCare Health Plans Researches and processes institutional and/or professional claims. Department: Ops-Claims I Reports to: Supv. Claims Location: W Idlewild Ave Tampa, FL Essential Functions: Processes claims that pend for various hold reasons to assist in the final determination on claim disposition. Processes adjustments related to projects or provider disputes. Researches post payment claims issues and takes necessary action for correction. Research claims issues and works with other departments to resolve claim issues. Assists with special projects as assigned or directed. Additional Responsibilities: Arizona representatives may provide provider phone coverage two days a week Candidate Education: Required A High School or GED Candidate Experience: Preferred 1 year of experience in Previous claims or health insurance Candidate Skills: Beginner Ability to multi-task Beginner Ability to work independently Beginner Ability to communicate and make recommendations to upper management Intermediate Demonstrated interpersonal/verbal communication skills Beginner Demonstrated written communication skills Beginner Demonstrated analytical skills Beginner Demonstrated problem solving skills Beginner Demonstrated time management and priority setting skills Beginner Demonstrated organizational skills Beginner Knowledge of healthcare delivery Licenses and Certifications: A license in one of the following is required: Technical Skills: Required Beginner Microsoft Outlook Required Beginner Microsoft Word Required Beginner Microsoft Excel Languages: About us Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 5.5 million members nationwide as of September 30, 2018. WellCare is a Fortune 500 company that employs nearly 12,000 associates across the country and was ranked a "World's Most Admired Company" in 2018 by Fortune magazine. For more information about WellCare, please visit the company's website at www.wellcare.com. EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.
Professional Diversity Network Tampa, FL, USA Full-Time