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Claims Processor III

Role overview

Qualifications

  • 2 years Customer Service skills
  • 2 years Admin
  • 2 years Health Plan Disbursements
  • Minimum of 18 months claims processing experience

Responsibilities

  • Meet or exceed current claims processing standards
  • Ensure financial, check, and processing accuracies
  • Process claims accurately and efficiently

Key facts

  • Remote from: Florida (USA)
  • Full time
  • Senior (5-10 years)
  • English

Other skills

  • Customer Service

About the company

Sentara Healthcare logo

Sentara Healthcare

Hospitals & Health Care

Sentara Health celebrates a 130-year history of innovation, compassion, and community benefit. Based in Norfolk, VA, Sentara is a diverse not-for-profit family of 12 hospitals, an array of integrated services, and a team of nearly 30,000 strong on a mission to improve health every day. This is pursued through a disciplined strategy to achieve Top 10% performance in key measures through shared best practices, transformation of primary care through clinical integration and strategic growth that adds value to the communities we serve in Virginia and North Carolina. Like us on Facebook at www.facebook.com/sentarahealth Follow us on Instagram at @SentaraHealth

Company details

Company typeXLarge
IndustryHospitals & Health Care
Company size10001

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Job description

City/State

Tallahassee, FL

Work Shift

First (Days)

Overview:

Sentara Health Plans is hiring an Claims Processor III - Remote in Florida!

 This is a Full-Time position with day shift hours and great benefits!

Job Requirements:

  • 2 years Customer Service skills

  • 2 years Admin

  • 2 years Health Plan Disbursements

  • High school Diploma /or Equivalent

  • CPC Preferred

Minimum of 18 months claims processing experience. Must meet or exceed current claims processing standards to include: financial, check and processing accuracies. CPC Certification OR Related Medical Certification OR 5 years direct claims processing experience OR Associates degree (or higher) required.

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.

Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.

We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help our members improve their health.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-101435

Talroo - Health Plan

Keywords: Health Plan, Healthcare, Health Insurance, MCO, Managed Care, Remote, FL, Claims

Benefits: Caring For Your Family and Your Career
Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down – $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
•Pet Insurance 
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.


In support of our mission “to improve health every day,” this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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