(USA-KY-Louisville) Claims Analyst – Pet (Veterinary Technician)
Home View All Jobs (2,368,707) Nationwide Claims Analyst – Pet (Veterinary Technician) in Louisville, Kentucky
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TASK SUMMARY: Promptly and effectively takes care of all new and also possible clinical cases in accordance with the firm plans and also treatments; follows Department of Insurance policies. Demands, puts together, as well as examines in detail, protection and/or medical record details in order to identify the correct case adjudication activity. Gets in accurate coding information in the system making sure that the sent invoice balances with the system input information to finish the insurance claim adjudication process.
Task Description
These positions can be completed either our Brea, CA workplace or can be Work From Home/Virtual
REPORTING RELATIONSHIPS: VPI Claims Supervisor
CORE JOB DUTIES & RESPONSIBILITIES:
Promptly as well as successfully processes all brand-new and potential medical insurance claims in accordance with the appropriate work flow. Evaluation vet medical diagnosis as well as codes cases in accordance with policy provisions. Makes sure conclusion of claims by coding as well as processing or sending out claims to appropriate operations.
Establishes coverage (i.e., pre-existing conditions, breed particular and/or hereditary problems) and approves advantages as well as qualification of each case based upon the terms of the plan.
Precisely refines claims based on well-known requirements, provider contract strategy and also employer team stipulations.
Requests, reviews as well as examines asked for clinical records or therapy notes for resolution of resolving insurance claims.
Makes sure correct paperwork in conformity with Company plans and methods. Tape-record the final personality of insurance claims, including denial and/or providing payment.
Notifies and determines administration of doubtful claims.Identifies and also notifies administration of doubtful dangers. Carries out other tasks as appointed.
MINIMAL JOB REQUIREMENTS:
Education: Undergraduate level in Biology, Zoology or related Animal Science area chosen.
License/Certification/Designation: State licensing and/or other certification as called for. Associates should get the needed Federal and/or state licenses/registrations within the time duration designated by the service system. Extra licenses/registrations might be called for when new services and products are applied. If an associate falls short or is incapable to acquire required licenses/registrations within the moment duration marked by the business device, the associate possibly ineligible to continue in the setting
Experience: 3-5 years of veterinary cases experience or equivalent training in a vet Clinic/ medical facility position under the supervision of a veterinarian veterinarian/veterinary technician chosen.
Knowledge: Proven understanding of veterinary clinical methods as well as treatment. Capacity to comprehend and use VPI’s insurance coverage endorsements, policies as well as cyclists and also have the ability to acknowledge and solve suspicious coverage circumstances.
Skills/Competencies: Ability to read, examine, and analyze records. Ability to fulfill inner consumer requirements and also provide solution by notifying consumers of the insurance claims procedure and also making sure a favorable customer experience.
Staffing Exceptions to the above Minimum Job Requirements need to be accepted by the: employing manager’s leader as well as HRBP.
TASK CONDITIONS:
Overtime Eligibility: Eligible (Non Exempt)
Working Conditions: Normal workplace setting.
ADA: The above declarations cover what are typically believed to be vital and principal functions of this task. Details scenarios may enable or need some people appointed to the work to carry out a rather various mix of responsibilities.
Task Evaluation Activity: 12/2014 DC
Extra Job Description