Helping businesses accelerate productivity with back office needs such as call centers, workflow & claims adjudication.
Claims Examiner
Location
Florida
Posted
120 days ago
Salary
$17 - $18 / hour
Seniority
Mid Level
Job Description
Claims Examiner
Imagenet LLC
• Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies. • Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing. • Communicate with internal resources, and internal stakeholders to resolve claim discrepancies, request additional information, or clarify issues. • Participate in ongoing training and professional development activities. • Maintain accurate and detailed records of claims processing activities. • Review claim forms and supporting documents • Determine eligibility, verify data accuracy • Request additional information when needed • Process claims end-to-end • Identify and escalate complex or unusual claims for further review or investigation. • Participate in ongoing training and professional development activities. • Handle more complex claims with multiple services, providers
Job Requirements
- At least 1-2 years of experience working closely with healthcare claims or in a claims processing/adjudication environment
- Understanding of health claims processing/adjudication
- Ability to perform basic to intermediate mathematical computation routines
- Medical terminology strongly preferred
- Understanding of ICD-9 & ICD-10
- Basic MS office computer skills
- Ability to work independently or within a team
- Time management skills
- Written and verbal communication skills
- Attention to detail
- Must be able to demonstrate sound decision-making skills
Benefits
- Remote work offered
- Equipment provided
- Paid training to set you up for success
- Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k)
- Paid Time Off (PTO)
- 7 paid holidays
- A supportive team and a company that values internal growth
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