What are the responsibilities and job description for the Medical Claims Examiner/Eligibility Coordinator position at TIC Midwest, LLC?
Job Overview
We are seeking a detail-oriented and experienced Medical Claims Examiner/Eligibility Coordinator to join our healthcare team. This role is vital in ensuring accurate processing of medical claims, verifying patient eligibility, and maintaining compliance with healthcare regulations. The ideal candidate will possess strong knowledge of medical coding, billing procedures, and electronic health record systems, contributing to efficient claims management and patient service excellence.
Successful candidate will perform routine claims processing, process payments or rejections of benefits, answer incoming telephone calls and provide customer service to assist participants, calculate eligibility and coordination of benefits, request documents and other participant information as necessary, enter eligibility and dependent information in computer as required, and process voids, stop-payments, and refunds. Performs other duties as needed. Must have ability to learn claims processing software.
Successful candidate will perform eligibility calculations for health care benefits, monthly processing of self-payments, termination notices, COBRA notices, Qualified Medical Child Support Orders and death benefit claims processing. Runs reports, assists with mass mailings, and enters eligibility and dependent information in computer as required. Qualified candidate will also provide customer service via telephone and in person as needed. Performs other duties as needed.
Qualifications:
1. Graduation from high school or equivalent combination of training and experience with emphasis on CRT entry or keypunch experience, work processing and/or mathematics preferred.
2. Six months interoffice experience.
3. Must be conscientious, efficient and dependable.
4. Willingness and ability to meet deadlines on a daily, weekly and monthly basis.
5. Office skills including: data entry and calculator.
6. Ability to use office equipment including PC and systems, including Microsoft Office (including Word and Excel), copy machine, and fax.
7. Ability to establish and maintain effective working relationships.
8. Physical ability to: a) sit for long periods of time, b) bend stoop and stretch as required to operate file cabinet drawers, c) carry files, books and other types of office paperwork and, d) operate PC keyboard and other office equipment.
9. Ability to be bonded.
10. Ability to speak clearly to participants in English.
11. Ability to read and compose letters and other documents in English.
12. Ability to learn claims processing software.
Competitive Pay. Employer contributes to 401(k) with no employee match required. Life, AD&D, STD and LTD benefits provided at no cost to employee.
Equal Opportunity Employer
Pay: From $20.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Work Location: In person
Salary : $20