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Accentuate Staffing is currently recruiting for a Claims and Benefits Specialist to join a pharmaceutical company in the Cary area.   This position promotes the efficient processing of claims and claims productivity by: verifying and entering patient’s demographic and insurance information into practice management system; obtaining accurate identification numbers and eligibility information from insurance carriers via the Internet and/or phone; investigates errors generated from electronic claims submission.

Responsibilities:
• Communicates with providers regarding verification of patient and insurance demographic information.
• Investigates and responds to errors generated from electronic claims submissions.
• Assists in researching eligibility submission problems/new client submissions.
• Interfaces with other departments, external providers or clients, as may be required, to resolve errors.
• Initiates verbal and written correspondence to internal and external sources to verify patient and claim information.
• Verifies patient information using links to hospitals and web based sites.
• Coordinates activities with other team members to insure timely distribution of work to outside locations.
• Remains knowledgeable and current on third party requirements, and regulatory guidelines at the federal, state, and local levels.
• Assist in evaluation of reports, decisions, and results of department in relation to established goals.
• Serves as a member of the Front End Team. Performs duties necessary to ensure the team’s projects/goals are completed.
• Takes ownership of special projects, researches data and follows through with detailed action plans.
• Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties.
• Adheres to CHS, Department and HR policies and procedures.
• Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties.
• Performs other related duties as required and assigned.

Requirements:
• High school diploma (or equivalent) is required.
• One to two years of claims data entry or claims processing is preferred with demonstrated skills in problem solving, attention to detail, ability to learn and use multiple systems and effective written and verbal communication skills.
• Customer service experience and the ability to work independently are required.
• The position also requires knowledge of and experience in using information systems (Microsoft Word and Excel are preferred).