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DST Systems Health Care Claims Examiner II in Birmingham, Alabama

The speed of technology. The influx of data. Shifting regulations. Increased customer expectations.

That's where you'll find SS&C, helping clients find opportunity in ever-changing and complex customer, business, and regulatory requirements. Mastering complexity is a constantly changing and evolving challenge – one that only a few people can embrace and thrive upon.

If you see your opportunity in complexity, then we are the right fit for you.

Job Description:

Company Overview

SS&C is a global provider of investment and financial services and software for the financial services and healthcare industries. Named to Fortune 1000 list as top U.S. company based on revenue, SS&C is headquartered in Windsor, Connecticut and has 20,000+ employees in over 90 offices in 35 countries. Some 18,000 financial services and healthcare organizations, from the world's largest institutions to local firms, manage and account for their investments using SS&C's products and services..

Role Overview

Health Care Claims Examiner IIs analyze and adjudicate complex hospital and medical claims in accordance with policies and procedures established by the client. Responsibilities include adjudication of complex claims, including claims involving hospital inpatient bills, Coordination of Benefits, co-surgeons, multiple surgical procedures, dual entitled members, adjustments, worker's compensation, or motor vehicle accidents. Associates must meet or exceed production and quality standards for processing and follow documented policies and procedures. Health Care Claims Examiners IIs respond to client inquiries and process adjustments for all claim types in a timely and efficient manner. This may involve direct client contact. Health Care Claims Examiner IIs may be responsible for providing guidance and mentoring to less experienced associates, but will have no formal supervisory responsibility.

Responsibilities

  • Analyze and adjudicate complex hospital and medical claims in accordance with policy and procedure

  • Respond to Client inquiries in a timely and efficient manner

  • Communicate directly with clients

  • Perform special project assignments from time to time, such as research work, obtaining special authorizations, outbound calls and data entry

  • Cross train in different areas to expand knowledge base and develop new skills

Qualifications

  • High School degree and at least 1 year of related experience

  • Ability to multi-task with high attention to detail

  • At least 1 year experience working with Healthcare or Pharmaceutical claims

  • Experience working with Medicare, Medicaid, Affordable Act, Commercial, Small/Large Group and/or Pharmaceutical Benefits Management

  • Real passion for excellence in service and attention to detail

  • Keyboarding skills with the ability to type 30 wpm with detailed accuracy

Location:

Birmingham Alabama

SS&C is an equal opportunity employer and values a diverse and inclusive workplace. All qualified candidates will receive consideration for employment without regard to age, race, color, religion, genetic information, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law. For more information about Equal Opportunity in the Workplace please click here and here. SS&C is committed to working with and providing reasonable accommodation to job applicants with disabilities. If you are a qualified individual with a disability and need an accommodation or accessibility assistance to complete the online application, please contact us at PeopleCenter@dstsystems.com for assistance.

SS&C is a global provider of investment and financial services and software for the financial services and healthcare industries. Named to Fortune 1000 list as top U.S. company based on revenue, SS&C is headquartered in Windsor, Connecticut and has 20,000+ employees in over 90 offices in 35 countries. Some 18,000 financial services and healthcare organizations, from the world's largest institutions to local firms, manage and account for their investments using SS&C's products and services.

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