• Claims Keyer

    Job Locations US-IL-Aurora
    Posted Date 6 days ago(10/10/2018 2:29 PM)
    # of Openings
  • Overview



    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 theTriple Aim - Better Health, Better Healthcare and Lower Costs to individuals and their families who participate in our health plans.


    UNITE HERE HEALTH serves 100,000+ workers and 220,000 covered lives 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!



    Key Attributes:


    • Integrity – Must be trustworthy and principled when faced with complex situations
    • Ability to build positive work relationships – Mutual trust and respect will be essential to the collaborative relationships required
    • Communication – Ability to generate concise, compelling, objective and data-driven reports
    • Teamwork – Working well with others is required in the Fund’s collaborative environment
    • Diversity – Must be capable of working in a culturally diverse environment
    • Continuous Learning – Must be open to learning and skill development.  As the Fund’s needs evolve, must be proactive about developing new areas of expertise
    • Lives our values – Must be a role model for the Fund’s BETTER Culture and Mission (Better, Engage, Teamwork, Trust, Empower, Respect)


    This position is responsible for viewing and keying scanned images within the claims system. The Claims Keyer will data enter Health Insurance Claim Forms (HCFA), Uniform Bill 04 (UB), Superbills, vision, and dental claims. This position will reject documents received for individuals who are not Fund participants. Identifies the type of document received and reviews it for accuracy and completion.



    Essential Job Functions:


    • Performs filing and data entry for medical, dental and vision claims
    • Determines the appropriate form type to be keyed based upon the claim received
    • Screens claims for completeness of necessary information
    • Rejects illegible images and prints them out to be returned to sender
    • Scans, uploads and indexes images into the claims system
    • Adjudicates pre-processing claims and data enters claims according to established productivity and quality goals
    • Monitors inventory aging reports to insure claims are processed within time requirements
    • Processes claims on a first in, first out basis regardless of complexity or difficulty
    • Handles returned mail
    • Provides back up support for mail processing (opening, sorting, etc.)
    • Reviews and prepares incoming hard copy documents and processes or routes them appropriately for additional handling
    • Determines the need for additional information or documentation from participants, employers, providers, and insurance carriers
    • Performs other duties as assigned within the scope of responsibilities and requirements of the job
    • Performs Essential Job Functions and Duties with or without reasonable accommodation


    • High School Diploma or GED
    • 2 ~ 3 years of related experience minimum
    • 1 year of healthcare or medical terminology experience preferred
    • Medical billing and/or International Classification of Diseases (ICD) 10 or Current Procedural Terminology (CPT) coding experience preferred
    • Experience working with an automated claims processing system preferred
    • Experience with eligibility verification, coordination of benefits, medical provider selection, and subrogation preferred
    • Experience in an office production environment with quality goals related to healthcare benefits administration preferred



    Skills and Abilities:

    • Intermediate level Microsoft Office skills (PowerPoint, Word, Outlook)
    • Intermediate level Microsoft Excel skills
    • Ability to keying a minimum of 8,000 to 10,000+ keystrokes per hour
    • Manage competing deadlines and multiple projects in a fast-paced environment
    • Attention to detail, time management, organizational and data entry skills
    • Excellent written and oral communication skills

    • Strong interpersonal skills


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