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Claims Processor - Medical Associates Health Plans

Medical Associates, Dubuque, IA

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 preferred but not required. 

Other Skills - Insurance plan management program (AMYSIS) preferred but not required, word processing and proficent computer skills, composing professional emails, and multi line telephone.


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Job Details

Req Num --
ID 708110
Dubuque, IA
Positions 1
Full Time
Pay --
Banking/Mortgage/Financial Services
Clerical/Office Administration
Health Care
First Shift
Health Insurance
Dental Insurance
Life Insurance
Retirement Plan
Paid Vacation
Paid Sick Leave
Paid Holidays

Preferred Candidates

Years of Experience --
Education High School/GED

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