Claims Processor/Data Entry


Call Center and Customer Service

Advert ID




Job Type




Salary Range

Based on Experience

No. of Openings


Branch Information

Raleigh - Durham NC Area - (USA) 430 Davis Drive Suite 100 NC Morrisville , NC 27560 Phone : 855-591-7454



Job Description

Handles all claim and non-claim documents with a commitment of quality and timeliness. Prepares and processes incoming mail for further handling. Manages basic data entry processes. Data enters claims and applications for adjudication.

* Prepares documents by departmental processes in order to allow for coordination of benefits

* Forwards imaged work to appropriate areas, working re-scan report and maintaining/balancing tracking logs

* Scans and identifies documents quickly and in priority to manage daily work-flow and provide timely responses

* Processes returned claims and data enters all claim types into OCR or key from paper work-flow

* Processes individual enrollment applications including processing of credit card payments

* Prepares claims and makes informed decisions for priority claim processing in order to report daily information for data tracking

* Corrects claims that error out of the adjudication system

* Develops expertise in areas of specialized complicated claims in order to perform Coordination of Benefits for all lines of business.

* Actively identifies system issues.

* Experience in a production environment preferred

* Data Entry Skills: 4,476 keystrokes per hour with a 93% accuracy rate.

* Minimum of one-year claims environment preferred

* Experience with MS windows, medical terminology and scanner preferred.

* Attention to detail and strong analytic skills

* Effective oral and written communication skills

* Maintain highest standards of professionalism and customer service in all interactions with & between departments

* Ability to work in teams and independently

* Strong organization skills

* Ability to handle multiple tasks, make sound decisions, and meet deadlines in a fast paced environment

* Ability to understand the complexity of different Explanation of Benefits

On-site position

The team currently works on-site due to the critical support needed for paper function.