Leggett & Platt, Incorporated
Leggett & Platt, Incorporated is seeking a Senior Medical Claims Benefit Analyst to join our Medical Claims team at our headquarters in Carthage, Missouri. This role is a culmination of medical claims administration and critical thinking. We're looking for someone with strong comprehension of medical terminology and experience in interpreting medical coverage criteria. Your skills will be applied in making benefit determinations on complicated claims, and provider requests for pre-determinations of benefits or clarification on how we arrived at a processing decision. Further, you will provide administrative support to the Medical Claims Supervisor in the areas of claims inventory, production scheduling, training, and special projects.
Responsibilities include, but are not limited to:
*Adjudicate medical claims in accordance with the medical plan document(s), administrative procedures, and software procedures *Initiate corrective measures on claims processed incorrectly including requesting refunds, reprocessing claims with corrected information, and ensuring that all plan and administrative procedures regarding claims corrections are followed *Provide back up to the Medical Claims Center's Customer Service call lines *Apply medical knowledge to research and respond to complicated claim and provider questions *Assist in medical claim center administration in regard to repricing and other projects as assigned *Maintain accurate project time logs to facilitate studies regarding claims volume capabilities *Actively participate in continuous improvement efforts including initiating ideas to improve the quality and/or efficiency of the work performed in the Medical Claims Center
*Proficiency in understanding medical terminology in relation to procedures and diagnoses *Commitment to confidentiality and customer service *Excellent organizational and verbal/written communication skills *Strong attention to details and the ability to process high volumes of work quickly and accurately *Good time management and the ability to work within deadlines *Analytical/investigational reasoning and problem-solving skills *Above average keyboarding skills (speed and accuracy) *Proficient with Microsoft Office *Experience with menu driven system applications
We believe in continuous improvement and welcome applicants with similar predilection.
Since 1883, Leggett & Platt (NYSE: LEG) has been creating a wide variety of innovative products that can be found in most homes, offices, and automobiles. Today our growing company consists of 21,000 employee-partners in 130 manufacturing facilities throughout 23 countries. We are always looking for talented professionals to succeed and grow with us. We value innovative and passionate people with a track record of success. For more information, please visit www.leggett.com.
Equal Employment Opportunity/Affirmative Action/Veteran/Disability Employer
Leggett & Platt, Incorporated
Website : http://www.leggett.com
Leggett & Platt®, which pioneered sleep technology when it introduced its bedspring more than 125 years ago, is an S&P 500 diversified manufacturer. Serving a broad suite of customers that comprise a "Who's Who" of U.S. companies, Leggett & Platt conceives, designs, and produces a diverse array of products that can be found in most homes, offices, and vehicles. Founded in 1883, the company is made up of 20 business units, 18,000 employee-partners, and 130 facilities in 17 countries. Leggett & Platt continues to infuse its products with its trademark innovation, helping customers enjoy more comfortable lives.