Looking for a way to influence the health and healthcare of many?
If so, we’d love to hear from you! Our mission-driven organization is focused on the“Triple Aim” - Better Health, Better Healthcare and Lower Costs to individuals and their families who participate in our health plans.
UNITE HERE HEALTH serves 90,000+ workers in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!
The purpose of this position is to receive, examine, verify and input submitted claim data, determine eligibility status, and review & adjudicate claims within established timeframes. Will effectively utilize the RIMS/Javelina claim processing system and the IMAX document retrieval system in order to perform the day to day job functions of processing claims.
Minimum of 2 years experience in a group medical claim adjudication environment is desirable
Knowledge of the RIMS computer system is helpful
Experience with interpretation of benefit plans, including an understanding of limitations, exclusions, and schedule of benefits; and experience with eligibility verification, medical coding, coordination of benefits and subrogation
Minimum level computer skills in a Microsoft Office environment: Beginner-Intermediate
Bi- or Multi- lingual skills (written and verbal): A Plus
Effective communication skills, both orally and in writing is required