1 Claims Processor Job in Akron, OH
Summa Health is Hiring a Claims Processor Near Akron, OH
SummaCare is a Summa Health entity that offers health insurance in northern Ohio. As a regional, provider-owned health plan, SummaCare is based in Akron, Ohio, and provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2024 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits.
Responsible for accurate and timely processing of claims per regulatory and contractual guidelines. Reviews claims involving coordination of benefits, medical coding and authorization allocation. Understanding and application of cost containment techniques with vendor partnerships are utilized to reduce overall cost of claims while applying plan or line of business specific processing rules.
Formal Education Required :
- High School Diploma or equivalent
- One year experience in health insurance claims processing, health claims data entry including Document Management Services (DMS), customer service experience in a managed care environment, physician or hospital billing, and/or patient accounts
- Word and Excel at a basic level. Must achieve passing score on test administered by Human Resources
- MS-windows based computer environment
- Medical terminology, CPT, HCPCs and ICD-10 knowledge
- Familiar with professional (CMS1500) and institutional (UB-04) claim types
- Independent judgment and decision-making skills
- Close attention to detail with independent judgment, decision making and problem solving skills necessary to complete the task being performed
- Sit for prolonged periods of time
- Bend, stop and stretch
- Lift up to 20 pounds
- Manual dexterity to operate computer, phone and standard office machines
$17.55/hr - $21.06/hr
The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.
Job Summary
Full Time
Hospital
$39k-49k (estimate)
03/10/2023
06/24/2024
The job skills required for Claims Processor include Customer Service, Problem Solving, Claim Processing, Attention to Detail, Data Entry, Health Insurance, etc. Having related job skills and expertise will give you an advantage when applying to be a Claims Processor. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Claims Processor. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Claims Processor positions, which can be used as a reference in future career path planning. As a Claims Processor, it can be promoted into senior positions as a Claims Clerk III that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Claims Processor. You can explore the career advancement for a Claims Processor below and select your interested title to get hiring information.
If you are interested in becoming a Claims Processor, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Claims Processor for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Claims Processor job description and responsibilities
Respond to customer questions, provide guidance on how to file claims and communicate to customers through phone call, email and chat systems.
02/12/2022: Springfield, OR
Claims Processor prepares daily reports for claims management team.
04/30/2022: Fort Myers, FL
Determines whether to return, deny, or pay claims according to organizational policies and procedures.
03/15/2022: Santa Cruz, CA
Claims Processor is responsible for inputting new claims, processing payments, conducting billing research and responding to telephone inquires.
03/06/2022: Helena, MT
For standard claims, a claims processor can calculate the claim amount and pay checks to clients.
04/14/2022: Greenville, MS
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Claims Processor jobs
The time to send the acknowledgement email for each of the claims case should be set based on the customer type.
04/26/2022: Fresno, CA
An onset date should be recorded on all accident related claims.
02/19/2022: Greensboro, NC
Stop Wasting Time on Manual Administrative Tasks.
02/18/2022: Wilmington, DE
Deliver a Top Notch Client Experience.
03/12/2022: Sarasota, FL
When they’re not verifying and paying claims, processors have several administrative responsibilities.
03/02/2022: Cleveland, OH
Step 3: View the best colleges and universities for Claims Processor.
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