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.
This role…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: $12.37 - $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:
- Medical, Dental, and Vision insurance
- Employer Paid Basic Life Insurance and AD&D
- Voluntary Life Insurance (Employee/Spouse/Child)
- Health Care and Dependent Care Flexible Spending Accounts
- Pre-Tax and Post --Tax Commuter and Parking Benefits
- 401(k) Retirement Savings Plan with Company Match
- Paid Time Off
- Paid Parental Leave
- Short-Term and Long-Term Disability
- Tuition Reimbursement
- Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)
Modivcare is an Equal Opportunity Employer.
- EEO is The Law - click here for more information
- Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
- We consider all applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, handicap or disability, or status as a Vietnam-era or special disabled veteran in accordance with federal law. If you need assistance, please reach out to us at [email protected]
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What We Do
Modivcare is leading the transformation to better connect people with care, wherever they are. We serve the most underserved by facilitating non-emergency medical transportation, monitoring, and personal and home care to enable greater access to care, reduce costs, and improve outcomes. We believe social and economic factors such as where you live, work or learn should never be a barrier to care. These factors, known as the social determinants of health, lead to inequities in our healthcare system and it’s our mission to close that gap by making connections to care. To make a world of difference, one member at a time. That’s what drives us.
Why Work With Us
We work with a range of clients: public and private payers, health systems, hospitals and universities. All united in purpose to better connect people with care. If you want your work to positively impact the lives of others, we want to hear from you.
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