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Medical Claims Specialist

Company: Planstin
Location: Saint George
Posted on: May 3, 2021

Job Description:

Located in sunny Southern Utah, Planstin is quickly becoming a leader in administering benefits and providing related business services. As health insurance continues to become more complex and costly, Planstin has made a significant impact in the healthcare industry by keeping costs low and providing exceptional service to employers and individuals alike. It is no wonder Planstin is such a fast-growing company as many are turning to Planstin for our unique solutions. If you are looking for amazing opportunities and have a desire to grow your career, Planstin may be the place for you. We have remarkable employees, offer a generous benefits package, and foster a culture of development, innovation, and integrity.


If you love helping people and making a difference in their lives, the Medical Claims Specialist may be the position for you. You will have the opportunity to work with medical providers and members to assure accuracy in claim approvals, denials, submissions, and payments for all their medical-related expenses. You will be able to take away the headache of the sometimes complicated world of benefits.

You will have the opportunity each day to make a difference by:

  • Coordinating with group Health Share to ensure a smooth transition for members with Zion needs.
  • Processing claim forms and helping to determine payout amounts.
  • Processing claims forms and creating explanation of benefits for members and providers.
  • Resolving issues between providers and members regarding payments made or received.
  • Willingness to continually learn medical terminology and well as billing codes necessary for submitting claims.
  • Processing non-standard claims and determining member reimbursements when applicable.
  • Answering incoming calls to advise providers of eligibility and benefits.
  • Answering incoming calls to advise providers of claim status.
  • Providing clarifications to providers and members on explanation of benefits.
  • Managing shared email boxes pertaining to claims and providers.
  • Performing other related duties as assigned.

This job may be for you if you have:

  • Excellent communication skills including active listening.
  • Ability to multi-task while maintaining accuracy in data entry.
  • Proficient computer skills with the ability to learn new software.
  • Be highly organized and show a high attention to details.
  • High school diploma.
  • Medical claims coding experience preferred.
  • Medical terminology preferred.

Job Posted by ApplicantPro

Keywords: Planstin, Saint George , Medical Claims Specialist, Other , Saint George, Utah

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