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An established health services organization based in New York City has an immediate opening for a Claims Clerk – Customer Services. Our ambulatory care facilities are staffed with a wide range of health professionals to provide extensive medical and diagnostic services.
The Claims Examiner is responsible for medical claims processing on the MCO claim system. Other responsibilities will be claims data entry, claims adjustment, provider service phone inquiries, claims scanning reviews, and Accounts Receivable requests.
Position Qualifications:
· Good business acumen with a customer focus and service orientation
· Knowledge of core claims related coding such as CPT4, HCPCS, ICD10
· Knowledge of medical forms, medical coding, and medical policy pertaining to insurance claims
· Must meet and/or exceed qualitative and quantitative production standards
· Provide informational resource for other employees
· Strong communication (written/oral) skills
· Interact with physicians to answer claims related questions and work through adjustment requests
· Claims payment systems experience required
· Familiar with MS Office Suite
We offer a competitive salary including, but not limited to, the following benefits:
· Medical, Dental, Pharmacy and Vision health benefits at no cost to all benefits-eligible employees and their eligible dependents
· Paid Time Off (Vacation, Personal, Sick days, and 12 paid Holidays)
· 401(k) Plan
· Life Insurance
· Tuition Reimbursement
· Mental Health Coverage
· Legal Services Benefit
· Gym Membership Reimbursement
Short Term and Long Term Disability Benefits
Email resume. EOE
Job Type: Full-time
Pay: From $61,000.00 per year
Benefits:
Schedule:
Travel requirement:
Work setting:
Work Location: In person
Full Time
Retail
$76k-97k (estimate)
03/11/2024
07/06/2024
thchealth.com
DENVER, CO
25 - 50
Private
$5M - $10M
Retail
The job skills required for Claims Examiner include Written Communication, Health Insurance, Life Insurance, Data Entry, etc. Having related job skills and expertise will give you an advantage when applying to be a Claims Examiner. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Claims Examiner. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Claims Examiner positions, which can be used as a reference in future career path planning. As a Claims Examiner, it can be promoted into senior positions as a Claims Examiner III that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Claims Examiner. You can explore the career advancement for a Claims Examiner below and select your interested title to get hiring information.
If you are interested in becoming a Claims Examiner, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Claims Examiner for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Claims Examiner job description and responsibilities
Most medical claims examiners deal with paperwork on a daily basis and they are expected to work on multiple claims per day.
04/03/2022: Springfield, MA
Each claim often comes with supporting documents such as medical records and hospital bills and examiners need to look over each file carefully.
03/08/2022: Manchester, NH
Claims examiners are responsible for approving or rejecting claims or arranging settlements.
01/25/2022: Santa Fe, NM
Examiners may review medical bills or accident reports and they may consult specialists.
01/30/2022: Santa Barbara, CA
The Claims Examiner maintains a full case load of professional liability claims.
01/24/2022: Monroe, LA
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Claims Examiner jobs
Keep reading to learn more about a claims examiner role.
03/28/2022: Oklahoma City, OK
Candidates should know that having a critical thinking and outstanding decision-making give examiners the logic and reasoning to evaluate and resolve claims.
04/05/2022: Tulsa, OK
Most employers require or strongly prefer medical claims examiners that have some medical background such as a postsecondary diploma.
03/11/2022: San Antonio, TX
To determine whether a claim should be rewarded, an examiner must be aware of the red flags associated with fraudulent claims and possess detailed analysis skills.
01/30/2022: Bellingham, WA
To begin a career as a medical claims examiner, one must first learn certain knowledge and skills that will help them execute the duties of the job.
02/17/2022: Lawton, OK
Step 3: View the best colleges and universities for Claims Examiner.