Senior Medical Claims Processor - Healthcare

Our client, a large 3rd party Administrator that processes accurate insurance payments for thousands of individuals, is seeking a senior level candidate to process medical claims.

Monday through Friday 40 hours per week: 11:30am - 8:00pm

Pay: $23.00 to $25.00 Per Hour

Easy to get too, Rural town, Free Onsite Parking, Café in Building!

Job Responsibilities:

This is a fast paced / high volume department that answer phones and respond to client inquiries related to payments made on their behalf to insurers or medical providers.

Lead the claim team through managing, training and promoting team work.
Ensure service contract guarantees are met.
Act as a resource and point person to the team for any escalated issues, questions, concerns etc.
Update policies and procedures.
Recommend process and workflow improvements.
As needed make outgoing calls to clients, medical providers, insurance companies to resolve coding, payment, billing, and documentation clarification.
Assist in identifying, researching and resolving client issues.
Uses knowledge of Medicare, Medicaid and commercial insurance along with primary and secondary insurance claims

Required Skills:

Experience with Medical Insurance including- Insurance follow up / Medical billing and payment / Billing resolution/ Insurance Claims
Understanding of Medicare, Medicaid, commercial insurance and secondary insurance
Ability to read and understand missing Clinical Documentation, Clinical coding Enrollment; and Payment Terms related to insurance premiums and out of pocket expenses; Benefits Coordination with other insurance coverage.
STRONG COMMUNICATION SKILLS–This is a highly interactive role . The chosen candidate will have experience with customer service/ call center experience from an Insurance, billing or medical processing payment environment.
Technology and Computer Skills: Proficiency with all MS Office applications (Excel, Word, Outlook, etc.) Billing and Insurance Software
Ability to speak Spanish preferred

Work for a highly rated Recruiting & Staffing Firm by Google and Forbes!

INDH