Claims Processor- Health Choices, Medical AssociatesMedical Associates, Dubuque, IA
Our mission is to provide superior healthcare and an excellent patient experience.
Medical Associates Clinic is a well-established multispecialty group practice with over 170 providers and a staff of over 1,000 health care professionals and support personnel. The group was founded in 1924 and is Iowa’s oldest multispecialty group practice. Today, Medical Associates Clinic is the area’s leading health care provider and only multispecialty group practice. Medical Associates Clinic has been recognized since 1998 as a “better performing practice” by the Medical Group Management Association.
In 1982, Medical Associates developed the Tri-State’s first health maintenance organization, Medical Associates Health Plans, which offers comprehensive health benefits to over 400 employers and 45,000 members. Medical Associates Health Plans has maintained an “Excellent” rating, the highest level of accreditation possible by the National Committee for Quality Assurance, for 13 consecutive years.
Medical Associates Clinic offers several locations from which to seek medical care, including facilities at 1500 Associates Drive, 1000 Langworthy, and 1940 Elm Street in Dubuque, Iowa; as well as facilities in Bellevue, Cascade, Dyersville, Elkader, and Monona, Iowa; Cuba City, and Platteville, Wisconsin; and Elizabeth and Galena, Illinois.
Medical Associates Health Choices is seeking a full-time Claims Processor to join the Claims Department team! Desired candidates will have strong dedication to excellent customer service that shines over the phone, through written correspondence, and with colleagues. On a daily basis, this person will utilize their professional oral and written communication skills along with their ability to collaborate successfully with a team. Additionally, a successful person in this role will be organized and efficient at multi-tasking, may have some prior claims processing experience, and be proficient at Microsoft Excel and typing.
Schedule/Hours: Monday - Friday between 8am - 5pm, 40 hours/week. This position includes full benefits!
Location: Our offices are located at 1605 Associates Dr. Dubuque, IA (near Medical Associates West Campus)
Essential Functions & Responsibilities:
Examine, process, calculate, and pay claims after verification of fee schedules and contract benefits in compliance with state laws, employer contracts, policies and procedures, and production standards established by the company.
Provide customer service to claimants, providers, and clients in resolving claims issues according to plan policies. Assist Health Plan staff when needed with new and renewal group presentations to explain benefits of Plan and assist in answering questions.
Assist Managed Care and Subrogation Specialist to endure timely resolution of claims pended for subrogation and medical authorization.
Possess knowledge of all health plan benefit plans and provide interpretation to all constituents including potential members, brokers, members, providers, employers, and Medical Associates Clinic and Health Plans staff.
Make appropriate adjustments to previously adjudicated claims and maintain coordination of benefit files.
Knowledge, Skills and Abilities:
Education - Equivalent to a high school education.
Experience - One to three years of similar or related experience.
Other Skills - Insurance plan management program (AMYSIS), word processing, adding machine, and multi line telephone.
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