Are you passionate about making a difference in people's lives? Do you enjoy working in a service-oriented industry? If so, this opportunity may be the right fit for you!
Modivcare is looking for a Claims Specialist I to join our team. This position is responsible for processing and managing claims submitted by providers, including verifying the accuracy and completeness of documentation and attachments.
Reviews incoming claims and related documentation to ensure accuracy and completeness.
Inputs claim data and pertinent information into the claims processing system.
Reviews company policies to determine coverage and assess the validity of claims.
Uses standard scripts or form letters to request missing information.
Applies established guidelines and policies to determine claim eligibility and process accordingly.
Communicates with providers when necessary to obtain additional information or clarify claim details.
Adheres to departmental policies, deadlines, and procedures for claim handling.
Reports suspected fraudulent claims to the Fraud, Waste, and Abuse (FWA) department.
May participate in special projects or perform other duties as assigned.
High School Diploma required.
Zero (0) plus years of experience.
Or equivalent combination of education and/or experience.
Strong attention to detail and data entry skills to ensure claim accuracy.
Basic computer proficiency, including Microsoft Word, Excel, and Outlook.
Analytical mindset with the ability to interpret claim data and follow established procedures.
Effective verbal and written communication skills with a superior customer-focused demeanor.
Problem-solving skills to address claim discrepancies and issues.
Ability to work both independently and as part of a collaborative team.
Salary: $14 - $16/hr
Modivcare’s positions are posted and open for applications for a minimum of 5 days. Positions may be posted for a maximum of 45 days dependent on the type of role, the number of roles, and the number of applications received. We encourage our prospective candidates to submit their application(s) expediently so as not to miss out on our opportunities. We frequently post new opportunities and encourage prospective candidates to check back often for new postings.
We value our team members and realize the importance of benefits for you and your family.
Modivcare offers a comprehensive benefits package to include the following:
Modivcare is an Equal Opportunity Employer.
Modivcare is a technology-enabled healthcare services company, which provides a suite of integrated supportive care solutions for public and private payors and their patients. Our value-based solutions address the social determinants of health (SDoH), enable greater access to care, reduce costs, and improve outcomes. We are a leading provider of non-emergency medical transportation (NEMT), personal care services, and monitoring.
