Claims Specialist Menomonee Falls, WI 53051/en-US/skygen_careers/job/Menomonee-Falls-WI-53051/Claims-Specialist_R200/apply Job Purpose:nbsp; Responsible for ensuring departmental tasks are completed in order to meet client turnaround times for claim payment and authorization determination. Responsible for special handling requests to support both internal and external requirements.nbsp; Essential Job Responsibilities: Provide second tier support to data entry processors by providing direction how to resolve authorization and claim discrepancies according to client business rules. * Manage specialized workflows to support client requests that deviate from standard processes and procedures.nbsp; Coordinate resolution with required departments as necessary. * Responsible for ensuring all reporting is reviewed, work queues are completed, and open issues are resolved prior to claim payment and authorization review.nbsp; Proactively communicate readiness to transfer data to appropriate departments. * Ensure that claims and authorizations that cannot be processed are rejected appropriately and notification is sent to the health care provider. * Proactively communicate potential issues to management to allow for timely resolution. Additional Responsibilities: * Assist with training to new staff members. * Conduct Quality Review of processors claims and authorizations according to established data entry guidelines. * Enter authorizations and claims while meeting department production and accuracy rates. * Contribute to the team effort by accomplishing additional responsibilities as needed. * Identify potential training opportunities and provide recommendations for process improvements. Minimum Qualifications: * Required Level of Education, Licenses, and/or Certificates * High school diploma or equivalent. * Required Level of Experience * 1 -3 years of experience in office role including data entry (i.e. accounting, billing, financial services, etc.) * Required Knowledge, Skills, and Abilities * Ability to work effectively with multiple interruptions. * Ability to organize work appropriately to meet deadlines. * Excellent attention to detail. * Ability to utilize resources to solve problems independently. * Ability to analytically approach problem solving. * Strong verbal communication skills. Preferred Qualifications * Preferred Level of Experience * Previous experience in working with dental, medical, and/or physical therapy claims. * Preferred Knowledge, Skills, and Abilities * Strong 10-key data entry/typing skills Posted 2 Days AgoFull timeR200 SKYGEN USA is dedicated to transforming the delivery of health benefits through innovative, technology-enabled solutions that drive down the cost of care while ensuring healthier outcomes for all Americans. We deliver world-class software solutions designed for next generation benefits management, creating unprecedented levels of automation and cost savings to power the most efficient health plans in the country. Why work here We are not complacent. nbsp;Our culture is one where innovation is the goal, hard work is expected, and creativity is rewarded. SKYGEN USA employees enjoy competitive salaries, excellent health benefits, and a network of like-minded co-workers who drive innovation across the entire healthcare technology industry. nbsp;Our culture is one of: nbsp; nbsp; nbsp; nbsp; Respect nbsp; nbsp; nbsp; nbsp; Ownership nbsp; nbsp; nbsp; nbsp; Innovation nbsp; nbsp; nbsp; nbsp; Integrity At SKYGEN USA, you will have opportunities to work with people who are as passionate as they are talented, develop yourself and your skills, and create valuable relationships every day. Our goal is to transform the delivery of healthcare benefits and make the landscape as efficient and automated as possible for the constituents we serve - including payers, providers and members. nbsp;We are constantly looking for brilliant employees with an entrepreneurial spirit who are hardworking, focused, and have a passion for innovation. nbsp; Were an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. SKYGEN USA isnbsp;committed to providing employees with a work environment free of discrimination and harassment.