Claims Processor III - Remote

Sentara Health Plan is currently hiring a Claims Processor III
- Remote!

Status:
Full-time, permanent position (40 hours)

Work hours: 8am to 5pm EST, M-F

Location: Remote opportunities available in the following states:
Virginia, North Carolina, 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 (state), West Virginia, Wisconsin, Wyoming

Responsible for all areas of customer service as it pertains to the acquisition and/ or retention of members for Sentara Health Plan, Inc. This includes functions associated with the administration of all group information: processing of claims, interaction with member, providers and employers.

• HS
  - High School Grad or Equivalent REQUIRED

• CPC Certification OR Related Medical Certification OR 5 years direct claims processing experience OR Associates degree (or higher)
  REQUIRED

• Minimum of 18 months claims processing experience.
• Must meet or exceed current claims processing standards to include: financial, check and processing accuracies.
• 2 years of Administrative experience REQUIRED
• 2 years Customer Service REQUIRED
• 2 years Health Plan Claims Disbursmnts 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!