Claim/Pend Specialist at Horizon Blue… · Remote

Summary: Horizon Blue Cross Blue Shield of New Jersey empowers members to achieve their best health and has been a health solutions leader for over 90 years. The Claim/Pend Specialist is responsible for initial claim pending resolution, claim adjustments, and data entry of claims and referrals into processing systems. Responsibilities: - Resolve edits on claims (pending resolution) and may require claim adjustments - Data entry of primary and secondary claims, as well as referrals into various processing systems - Return claims with unidentifiable information back to healthcare professional/subscriber with letter requesting additional information - Perform general clerical duties to ensure accurate disposition of claims/referrals that cannot be entered into the various processing systems - Perform other related duties as required by Management Required Qualifications: - High School Diploma or equivalent required - Requires one (1) year of clerical business experience - Must be proficient with the use of personal computers and supporting software in a Windows based environment, including MS Office products - Strong typing, data entry and keyboarding necessary - Must be proficient using a calculator for simple math calculations - Must be detail oriented with good organizational and data processing skills - Proven ability to follow detailed instructions is essential - Must demonstrate ability to learn quickly and apply learning to new situations - Must exhibit flexibility to change as appropriate Preferred Qualifications: - Medical Terminology/Billing/Coding experience preferred - Experience in a Production and Quality driven work environment preferred - Should be knowledgeable in the use of intranet and internet applications; including ability to navigate Required Skills: Medical Terminology, Medical Billing, Medical Coding, Data Entry, Microsoft Office, Windows environment, Typing, Calculator use Benefits: Comprehensive health benefits (Medical/Dental/Vision), Retirement Plans, Generous PTO, Incentive Plans, Wellness Programs, Paid Volunteer Time Off, Tuition Reimbursement