Job Responsibilities
My major responsibilites are to process high -dollar hospital
and professional claims in a timely mannerand with no errors; in
other words, our claims should not be more than 7-business days
old; as for error, we can only have 1 1/2 errors per year,
that's hard to do but it can be done as I did it before. I check
each claim manually for any errors, like mispelled name of
patient, date of birth, relation, if they are the subscriber or
the dependant. Next I have to see why the claim didn't pass
through our system and pay. Usually it will be because a
diagnosis or procedure code being used is either incorrect, no
longer in use, or that the claim is a high dollar claim and
needs to be checked manually to make sure every line is being
paid correctly. Sometimes I will have to request medical records
from the provider to see if the patient really needs what is
being done and send these records over to our Medical review
department and they will then adivse me on how to pay the claim
or reject the claim.
|
Job Requirements
Hiring requirements: a high school diploma or equivalant; if you
are going to college, alot of times blue cross will hire
students from local colleges here if they are studying computer
classes or any other class that will help them if they are hired
in the future. They work parttime and they must maintain no less
than a A-B average to stay working.
|
Uppers
The most I like about my job is that everyone there is really nice and
understanding! When I first started working there, I ended up having a nervous
breakdown, 2-weeks after I had started working. Well, I went to the hospital and
stayed there 2-months and thought that my job was over. To my surprise, I was
told that it is hard to loose your job once your there and that I still had my
job when I get out of the hospital. I did and that is why I am still there.
They will also work around your schedule if you want to continue your education.
The time to start is from 6:30a to 8:p.m. and as long as you do 8-hours in a day
they really don't care when you start, unless part of your job is to be taking
phone calls.
|
Downers
The only down side to this job is nothing really. I can't think
of anything except when we have meeting in the office, well then
I have to attend them but they are only twice per month and when
you work out of your home, you really don't like going in even
for meetings!
|
Lifestyle
Well, when I worked in the office, my hours were 7a-3p; with a 1/2hour lunch and
2-15 minute breaks which you can take all at once as a 1-hour lunch. Every year
we have an employee appreciation day where the company will bar-B-Que and have
outdoor activities for us behind the building and gifts and contests. It's lots
of fun. We also have the opportunity to volunteer for Habi-Jax, where you go help
build houses for low income families and you get paid a regular work day for it.
We also have days of recognition for outstanding workers that will have a
luncheon and get a trophey or whatever they are giving and prizes. Since the
company met their goals for 2005, they are letting us have casual dress down for
the whole 2006. As long as no t-shirts aren't worn w/ saying; but you can wear
jeans as long as they have no holes, tennis shoes that look clean, and everyone
does. People think this is a hard job, it's only hard if you make it hard. You
just have to take it one step at a time and learn all you can. They have a
3-month learning curve so after your trained, you have 3-months to make errors
that will not count against you. You will have a quality coach that will tell
you what your error was and how to correct it. These people where I work, I don't
know where they found them because I have never had anyone one get mad at me or
yell at me for doing something wrong. These are really nice people to work for.
|
Compensation
I started at $8.50 per hour back in 1998 and now I am up to
$16.06 per hour.We get an Employee incentive bonus every March
and it depends if your department reaches it goals and your
review goes well. Last year I had gotten a $850.00 bonus, this
year it was $1033.41. I also got a couple of raises last year
because they do surveys on what other insurance company are
paying their employees and if they aren't paying about the same
they will up your pay like they did me last year I got 2- raises
in one month.,the benefits are pretty good but blue cross is the
most expensive insurance there is and that's because they have
strict rules with the doctors and hospitals because they don't
like fraudulant claims so I would rather pay for blue cross
insurance knowing that they are careful about whose in the
program. We use Fidelity mutal and have stocks and you can put
up to 6% of your pay and the company will meet whatever you put
in.
|
Advice to Jobseekers
I would say go and try it, some like it some don't but it's up
to you, I care about our subscribers and I work each claim as if
it were my own, because I wouldn't want anyone working one of
mine as if I was just another paycheck. You can always move
within the company, if you don't like what your doing, then you
can see what other openings there are and apply for those. This
is a place to grow if you want a career and not just a job. I
have been with the company for 8-years and I went from working
on the phones to working claims and I a getting ready to apply
for an auditing position as soon as it becomes open. Once your
foot is in the door there is alot of that you can learn in this
company. The good thing is there is no working time limit to
change your position, if you were there 3-months and found a
position in another department you can apply, before you had to
be there 1-year before you could change.
|
|
