Job Detail

Job Summary

Claims adjuster level 1 , to ensure accuracy of claims records and payments in a fast-paced environment with the opportunity for growth.

Responsibilities: will include review and processing of claims, determining eligibility and claims inquiry. must meet and/or exceed qualitative and quantitative production standards. minimum 4 years medical claims experiences, knowledge of Medicare policies CPT/ICD-10 coding, Medical terminology and diagnosis Medicare fees schedule Radiology/Radiation, Labs, DME, AMB, physicians, injections strong PC skills analytical data entry and typing.

Job Duties:

• Review aging daily (professional HFCA)
• Read and interpret DOFR and Contracts
• Read and interpret EOC
• Production of 150 claims and 10 appeals
• other duties as assigned by the Supervisor
• develop claims
• process and pay claims EOB, Labs and x-ray

Requirements:

• 4 years managed care experience , including medical and/or hospital claims payment and/or billing required; certified preferred
• knowledge of general office equipment
• ability to deal with stress gracefully
• ability to work well both independently and with others in a team environment
• detailed oriented with the ability to follow directions
• cooperative team spirited attitude positive attitude
• Medicare and Medical claims guidelines

Job Type: Full-time

Pay: $40,000.00 - $60,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off

Physical Setting:

• Office

Schedule:

• 8 hour shift
• Monday to Friday

COVID-19 considerations:
Must be fully vaccinated and provide proof of vaccine

Education:

• High school or equivalent (Preferred)

Work Location: One location