Claims Processor, Brio Living Services
This a Full Remote job, the offer is available from: United States, Michigan (USA)
Schedule: Full Time | 40 hours per week
Location: Remote, with potential onsite time
The Claims Processor analyzes, supports, and executes functions within the claims adjudication process for PACE Shore-to-Shore (S2S), including LifeCircles PACE, Huron Valley PACE, and Thome PACE.
What youll do:
Claims Adjudication Process
Verifying proper authorizations and documentation before processing claims, with necessary follow-up
Data entry for claims processing
Tracking claim status and communicating with vendors
Handling claims denials
Claims Data Tracking and Reporting
Track and assist in reporting claims data for re-insurance and other key areas as assigned
Assist with monthly correspondence for True Out of Pocket (TOOP) cost tracking
Support monthly RAPs and EDS reporting, including resolving claim errors
Participate in monthly audits of RAPs return/output data
Team Collaboration and Skill Development
Actively participate in team meetings and training opportunities to stay current and enhance professional skills
Regulatory Compliance
Brio Living Services policies and safety guidelines
Federal, state, and local regulatory requirements
This is a summary of the position, and it is not intended to be an exhaustive list of all duties. If selected for the position, you will receive a complete job description.
What It Takes:
Associate Degree in Business, Accounting, Finance, or a related field, desired.
A combination of education and directly related experience may be considered.
Two years of previous financial experience.
Strong technology skills, including proficiency in computers, Microsoft Office (Word, Excel, Outlook), data entry, and system applications.
Why Brio Living Services?
Make an impact on the lives of older adults.
Comprehensive benefits, including Medical, Vision, and Dental Insurance, Retirement Savings Plan, and Wellness Program with Reimbursement.
Generous paid time off, 6 Paid Holidays, and 2 Floating Holidays.
Growth opportunities, including an Educational Scholarship Program and Tuition Reimbursement.
Req #:
Accessibility Support
Brio Living Services is committed to offering reasonable accommodation to job applicants with disabilities. If you need assistance or an accommodation, please contact us at [email protected].
Brio Living Services is an Equal Opportunity Employer
We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, or genetics, in accordance with federal, state, and local laws.
This offer from "Brio Living Services" has been enriched by Jobgether.com and got a 80% flex score.
Apply Now
Schedule: Full Time | 40 hours per week
Location: Remote, with potential onsite time
The Claims Processor analyzes, supports, and executes functions within the claims adjudication process for PACE Shore-to-Shore (S2S), including LifeCircles PACE, Huron Valley PACE, and Thome PACE.
What youll do:
Claims Adjudication Process
Verifying proper authorizations and documentation before processing claims, with necessary follow-up
Data entry for claims processing
Tracking claim status and communicating with vendors
Handling claims denials
Claims Data Tracking and Reporting
Track and assist in reporting claims data for re-insurance and other key areas as assigned
Assist with monthly correspondence for True Out of Pocket (TOOP) cost tracking
Support monthly RAPs and EDS reporting, including resolving claim errors
Participate in monthly audits of RAPs return/output data
Team Collaboration and Skill Development
Actively participate in team meetings and training opportunities to stay current and enhance professional skills
Regulatory Compliance
Brio Living Services policies and safety guidelines
Federal, state, and local regulatory requirements
This is a summary of the position, and it is not intended to be an exhaustive list of all duties. If selected for the position, you will receive a complete job description.
What It Takes:
Associate Degree in Business, Accounting, Finance, or a related field, desired.
A combination of education and directly related experience may be considered.
Two years of previous financial experience.
Strong technology skills, including proficiency in computers, Microsoft Office (Word, Excel, Outlook), data entry, and system applications.
Why Brio Living Services?
Make an impact on the lives of older adults.
Comprehensive benefits, including Medical, Vision, and Dental Insurance, Retirement Savings Plan, and Wellness Program with Reimbursement.
Generous paid time off, 6 Paid Holidays, and 2 Floating Holidays.
Growth opportunities, including an Educational Scholarship Program and Tuition Reimbursement.
Req #:
Accessibility Support
Brio Living Services is committed to offering reasonable accommodation to job applicants with disabilities. If you need assistance or an accommodation, please contact us at [email protected].
Brio Living Services is an Equal Opportunity Employer
We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, or genetics, in accordance with federal, state, and local laws.
This offer from "Brio Living Services" has been enriched by Jobgether.com and got a 80% flex score.
Apply Now