Claims: Mail Processor

JOB SUMMARY
Responsible for daily sorting and processing of incoming mail for all groups, including UB-04 and CMS-1500 claim forms. Ensure claims are accurately categorized by line of business, multiple service dates, PDR, appeals, and retro authorizations. Identify and forward Out-of-Area claims in compliance with regulatory requirements. Complete batch scanning of all documents once sorting is finalized.

QUALIFICATIONS

• High School Diploma or Equivalent
• Minimum two (2) years’ experience in the healthcare management managed care environment required; including third-party contracting, negotiating, reimbursements and analysis.
• Minimum two (2) years of experience in a management capacity.
• Preferred experience in managing analyzing and reporting denials and appeals.
• Requires an ability to communicate well, multitask and stay organized
• Knowledge of Microsoft (Word, Excel, PowerPoint)
• Strong computer and data entry skills

SKILLS

• Must have effective communication, facilitation, interpersonal and professional diplomacy skills.
• Strong attention to detail with ability to manage multiple priorities while meeting deadlines.
• Able to Problem-solve, negotiate and demonstrate independent decision-making.
• Strong communication skills in both oral and written form.
• Positive attitude and takes a team approach to management.
• Maintain strong skills in diplomacy, professionalism and trustworthiness.
• Familiarity with Microsoft applications, which include the ability to learn new computer systems and applications.
• Ability to manage multiple priorities and projects.
• Detail oriented with desire for producing work with 100% accuracy.
• Excellent analytical and problem-solving skills.

As an Equal opportunity employer, Choice Medical Group is committed to a diverse workforce. Employment decisions regarding recruitment and selection will be made without discrimination based on race, color, religion, national origin gender, age sexual orientation, physical or mental disability, genetic information or characteristic, gender identity, and expression, veteran status, or other non-job related characteristics or other prohibited grounds specified in applicable federal, state and local laws. In order to ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Era Veterans’ Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact this post for assistance.

• For more information about equal employment opportunity protections, please view the ‘EEO is the Law’ poster.
• NOTICE:

EMPLOYEE POLYGRAPH PROTECTION ACTYOUR RIGHTS UNDER THE FAMILY AND MEDICAL LEAVE ACTPAY TRANSPARENCY NONDISCRIMINATION PROVISIONOur environment respects individual differences and recognizes each employee as an integral member of our company. Our workforce reflects these values and celebrates the individuals who make up our growing team.Choice Medical Group provides a work environment free of harassment and prohibited conduct. We promote and support individual differences and diversity of thoughts and opinion.

Job Type: Full-time

Pay: $20.00 - $26.10 per hour

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience:

• Medical Claims : 1 year (Preferred)
• UB-04 and CMS 1500: 1 year (Required)

Work Location: In person

Salary : $20 - $26