Claims Coordinator

Job Summary

The Coord must be competent in all functions of a Claim Coord, Assoc and Coord, Claims in addition to more complex claim and issue resolution. Examples of complex claims may include: secondary claim coordination; customer inquiries; claims adjustments. This position is production and quality based and the Coord will be expected to achieve monthly measures.

Essential Functions

• Process claims through on-line adjudication. May include HMO, ASO, PPO, LFO POS, or GP. Processing will include complex claims such as secondary claim coordination, customer inquiries, claim adjustments and complex issue resolution.
• Utilize Lens Inquiry Tracking system to initiate and resolve claim related issues.
• Detailed knowledge of operational/technical functions and software.
• Ability to perform tasks in a high stress environment.
• Ability to complete multiple tasks in a timely manner.
• Ability to meet minimum production and quality standards
• Ongoing oral and written communication within teams.
• Assist in special projects as assigned.

Qualifications

Required

• High School Diploma or equivalent
• 2 years of relevant experience in related field

Preferred

•  Associate's Degree or equivalent

• 2 years of relevant experience Working knowledge of claim payment process and interdependence with other departments.
• 2 years of relevant experience working in an environment requiring production and quality minimums

About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

#CorewellHealthCareers

How Corewell Health cares for you

• Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.

• On-demand pay program powered by Payactiv

• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!

• Optional identity theft protection, home and auto insurance, pet insurance

• Traditional and Roth retirement options with service contribution and match savings

• Eligibility for benefits is determined by employment type and status

Primary Location

SITE - 1700 Magnavox Way Suite 201 - Fort Wayne

Department Name

Physicians Health Plan of Northern Indiana Admin - PH Managed Benefits

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

8 a.m. to 5 p.m.

Days Worked

Monday to Friday

Weekend Frequency

N/A

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Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.