We are looking for Experienced Claims Processors to join our rapidly growing team in Tampa. Experience is required for this position.

MUST BE LOCAL TO TAMPA

This position is based in our Tampa office. However, employees who consistently meet performance metrics are eligible for a flexible work arrangement that allows working from home.

Consistently meet or exceed all productivity and quality metrics for their role over a 3-4-month period

Demonstrate the ability to collaborate effectively and maintain strong communication with team members while working remotely

Have no active performance improvement plans or disciplinary issues

Once the above criteria are met, the employee may submit a request to work from home. Approval will be at the manager's discretion based on business needs and the employee's proven performance.

We strive to provide flexibility where possible to employees who have demonstrated success in their role!

Job Description

Analyze and adjudicate a complex variety of claim types to include facility, professional, inpatient and outpatient services

Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria

Review different lines of business to include Medicare, Medicaid and Commercial services adherence to the contracts and timeliness guidelines

Authorize claim payments within established limits; otherwise forward to Claims Manager

Potentially process refunds appeals, disputes and adjustments (when applicable)

Identify process improvement opportunities within the claim department and recommend system enhancements

Handles any additional responsibility which may be assigned

Education : High School Diploma or equivalent required

Experience :

Preference for minimum of two-year experience working closely with healthcare claims or in a claims processing / adjudication environment

Technical Skills / Qualifications :

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

Salary : $18.00-$19.00 per hour based on experience.

Benefits :

We offer great benefits, flexible hours, and the opportunity for remote work for self-disciplined candidates who can perform well under limited supervision.

Imagenet offers unlimited opportunities for candidates looking for upward mobility. Our leaders are always promoted from within and there is not a minimum employment time frame if you qualify for promotions.

We appreciate referrals and always look to reward employees who help us grow.

Dental insurance

Health insurance

Vision insurance

Performance Bonus

Referral Bonus

401K Savings Plan

Job Type : Full-time

Schedule : 8 hour shift

8 hour shift

Monday to Friday

Flexible schedule

Work Location : Hybrid remote in Tampa, FL 33618

Ability to commute / relocate :

Tampa, FL 33618 : Reliably commute or planning to relocate before starting work (Required)

COMPANY OVERVIEW

Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide.

Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans’ members and providers.

The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans’ members and providers.

The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually.

The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.

Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly-owned global delivery center in the Philippines.

Imagenet LLC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. 006868% %%insurance%%

Last updated : 2024-05-22