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CTG Claim Processor in Lexington, Kentucky

Claim Processor

Lexington, Kentucky, United States

Information Technology

Jan 06, 2020Post Date

20200166Requisition #

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Our client inLexington, KY has an immediate opening for aClaim Processor for a 4 month contract assignment (possibility of extension).

Essential job functions:

This position will be processing, a mix of FSA, HRA and HSA claims. For a claim to be eligible, the participant must submit a claim form and third-party substantiation. An example of a third-party substantiation is, documentation from the provider or the insurance company. The participant needs to provide a Claim Form along with supporting documentation. Supporting documentation must include the standard 5 (commonly referred to as the 'Magic 5') pieces of information from a third-party provider: Date of Service, Amount, Service Description, Dependent Name, and Provider Name.

As a Claim processor, you will be responsible for validating the data that has been submitted by the participant. This is done by reviewing the substantiation, with the knowledge that is received during training, select data elements are then entered into the system. Based on the data entered into the system, the claim will approve or deny.

Training – There is a 4 to 6 weeks training to ensure the rules are fully understood. Before anyone is release from training, they must pass the audit of 90% out of the last 100 claims processed. The training is done one claim type at a time, you must graduate from the first claim type to move to the next. There is only two-week time frame to get out of the audit, to move to the claim type, the expectation is 90% of the last 100 claims processed.

Quality – Each processor is responsible for their own quality, and must achieve 94% financial, and 92% document quality.

Productivity – Once out of training the expected productive is 56 claims per hour.

Shift Time – Monday – Friday, 8 am to clean desk – the end times will vary depending on the number of claims received, the normal time is 5 pm however this may change depending on volume. The goal is to have no overtime, however depending on the volume overtime may be required from time to time. This may include some Saturdays.

Additional Requirements, Skills and Qualifications:

Education - high school diploma or GED or higher

Typing skills – 5,000 key strokes or higher-Testing required

Computer knowledge – basic skills require

Medical Coding knowledge would be beneficial

CTG (NASDAQ: CTG) has developed a reputation for responsiveness and reliability - traits that our clients say set us apart - since our founding in 1966. Today, we provide comprehensive information, technology, and business solutions that address critical challenges for clients in high-growth industries in North America and Western Europe. Backed by a proven track record of reliable delivery, CTG fosters long-term client relationships and trust, which allows us to develop strategic insights that maximize client investments and competitive advantage. CTG has operations in North America, Western Europe, and India and regularly posts news and other important information online at www.ctg.com.

Our culture is a direct result of the people who work at CTG, the values we hold, and the actions we take. In other words, our people are the culture. It's a living, breathing thing that is renewed every day through the ways we engage with each other, our clients, and our communities. Part of our mission is to cultivate a workplace that attracts and develops the best people, reflected by our recognition as a Great Place to Work-certified company across many of our global operations.

CTG will consider for employment all qualified applicants including those with criminal histories in a manner consistent with the requirements of all applicable local, state, and federal laws.

CTG is an Equal Opportunity and Affirmative Action Employer. CTG will assure equal opportunity and consideration to all applicants and employees in recruitment, selection, placement, training, benefits, compensation, promotion, transfer, and release of individuals without regard to race, creed, religion, color, national origin, sex, sexual orientation, gender identity and gender expression, age, disability, marital or veteran status, citizenship status, or any other discriminatory factors as required by law. Our Affirmative Action program serves to promote occupational equality and diversity through good faith efforts. CTG is fully committed to promoting employment opportunities for members of protected classes.

Additional Information

  • Job Function: Administrative Assistant

  • Education Level: High School Diploma/GED (±11 years)

  • Work Remote: No

  • Travel: No

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