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.
This is a team that supports the West Coast; Please note the schedule below.
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!
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