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GIA Legacy Planning
🔹Licensed Life Insurance Agent – Remote Position
Flower Mound, Texas, United States · Remote Solely
Entry level
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Full-time
high school
Medical, Dental, Vision, Life Insurance, Long-term Disability, 401k
Posted 7d ago
~40 hrs/week
Responsibilities
The Audit Verifier is responsible for auditing and examining suspected medical, dental, and long-term care insurance claim overpayments. They must collaborate with team members to verify information, identify trends, and ensure all claims are processed in compliance with industry standards.
Requirements
Candidates must have a high school diploma or equivalent and at least two years of experience with Microsoft Excel. Proficiency in insurance claims examination and the ability to pass a skills test are required for this role.
Full job description
Description
Classification: Non-Exempt
Level: Tier I
Pay Range: Depends on Experience level
Reports to: Audit Supervisor
JOB DESCRIPTION
Summary/Objective
This position is responsible for auditing and examining suspected insurance medical, dental and long-term care claim overpayments that we identify on behalf of our insurance carrier clients. To be successful in this position, you must be self-motivated, detail oriented and independent.
Summary/Objective
This position is responsible for auditing, verifying and examining suspected insurance for medical, dental and long-term care claim overpayments that we identify on behalf of our insurance carrier clients. To be successful in this position, you must be self-motivated, detail oriented and independent.
Essential Functions
Verifies insurance data by reviewing spreadsheets, policy documents, and systems to identify overpayments;
Conducts detailed audits of insurance records and transactions;
Communicate with team members to train, support, and collaborate in the determination process of verifying information;
Ensures claims are reviewed and processed in a timely manner;
Possesses a strong attention to detail and identifies trends within files;
Provides written feedback with findings and recommendations on completed programs;
Ensures compliance with industry standards and regulatory requirements;
Collaborates with other departments to resolve audit findings;
Maintains current knowledge of insurance regulations and standards;
Responds to questions related to assigned insurance carrier;
Strives to uphold the core values of 6 Degrees Health - DMR, Be Polite, Be Persistent, and Be Proactive
Achieves daily, weekly, and monthly audit metrics;
Maintains an average of no more than four Never Overpaid True Audit Errors per month;
Understands how to review dental, medical and long-term claims and policy documents;
Audits the following overpayment programs: Claim Voids, True Duplicates, Adjustments, US Senior Care, and Terminated Policies; and
Performs other duties as assigned.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Requirements
Competencies
Ability to perform the essential job functions
Professionalism
Communication Proficiency – written and verbal communication
Must positively respond to coaching, mentoring and feedback
Customer/Client Focus
Problem Solving/Analysis
Ability to multitask
Committed to the mission of the company
Dedicated to the core values of the company
Attention to Detail
Must exhibit high levels of communication, teamwork, professionalism, reliability, respect, etc.)
Must have a basic level of polices & procedures
Supervisory Responsibility
This position has no supervisory responsibilities
Required Education and Experience
High school diploma or equivalent.
Two years of experience with Microsoft Excel is required.
Possess excellent interpersonal skills, oral and written communication skills.
Be able to work independently.
Must be able to focus on the task at hand for an entire day.
Be detail oriented, accurate, efficient, and precise in completing the tasks associated with the position.
Preferred Education and Experience
Post high school education or certification is preferred.
Experience reviewing dental, Medicare/Medicaid billing or auditing is preferred.
Proficiency with technology, especially computers and software applications. Have intermediate knowledge of Microsoft Excel and Word. Mainframe, “green screen” experience is preferred.
One year or more of experience with insurance claims examination or processing is highly preferred.
United Healthcare Dental
Eligibility Qualifications
Passing of skill test will be required.
Intermediate Windows & MS Office Skills are mandatory.
Must attend all days of onboarding training. If unable to attend all days of the training which are held in the first 30 days, the applicant will be rescheduled for the next available training. If unable to attend all days of the rescheduled training, the employee will be released from employment.
Internal Candidate Eligibility Qualifications
Must be regular employee who has completed their introductory period.
Cannot have any written warnings or performance improvement plans currently in place.
Problem-solving initiative in an 6 Degrees Health-DMR role as documented by their department director and/or performance evaluations.
Work Authorization
Candidates selected will be subject to a pre-employment background investigation (drug test, credit check, reference verification) and skills test.
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Compensation and Benefits
There will be an attractive compensation package that is commensurate with experience. 6 Degrees Health - DMR offers a full suite of benefits for full time employees. Those benefits include medical, dental, vision, life, LTD, 401k, PTO and holiday pay. Join our growing team based exclusively in Amarillo, Texas.
Position Type/Expected Hours of Work
This is a full-time position. Days and hours of work are Monday through Friday, 8 a.m. to 5 p.m. This position requires 40 hours per week with some time outside of the normal hours.
Travel
No travel is expected for this position.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee will be required to sit for extended periods of time and is frequently required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms.
This position requires sitting over 66% of the time.
This position requires Visual Acuity at 20 inches (or less) over 66% of the time.
AAP/EEO Statement
6 Degrees Health (DMR) is an affirmative action/equal opportunity employer (AA/EOE). All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, sexual orientation, disability status, genetic information, protected veteran status or any other characteristic protected by federal, state or local law.
Achieving Superior Cost Savings with Best-in-Class Service for Health Plans
Industry
Hospitals and Health Care
Company size
51-200 employees
Founded
2011
Headquarters
Portland, Oregon
LinkedIn followers
7,458
6 Degrees Health is a healthcare cost containment company dedicated to achieving superior results while prioritizing a best-in-class customer and member experience. We leverage both clinical expertise and innovative technology to deliver fair reimbursements and enhance payment accuracy.
Offices: 3439 NE Sandy Blvd., Suite 384, Portland, Oregon 97232, US
HealthcareSelf-insuranceReference Based PricingPayment IntegrityTransplantCatastrophic CareLegal Supportand Cost ContainmentHealth CareMedical
How much do Finance & Accounting jobs in Texas pay?
Based on 3665 listings with disclosed salaries, most finance & accounting jobs in Texas pay between $65k–$185k per year. Individual offers vary with seniority, company size, and specialization.
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