We're looking for a Claims Processor, working in the Insurance industry in Watertown, Massachusetts, United States.
Processes complex claims adjustments as assigned by supervisor.
Reviews complex adjustment request to determine if re-adjudication of claim is required.
Researches provider payment inquires related to pricing edits, contract pricing and/or medical coding.
Examines claim to correct and/or update data so claim can properly re-adjudicate.
Prepares and enters adjustment while applying appropriate back out and adjustment reason codes.
The pay we are offering is 20 per hour. This position may present an opportunity to go permanent.
Our client is an up and coming staffing company.
Growing by connecting clients with great technology, finance and accounting, project consulting, and executive talent. Talent like you. Taking time to build relationships. Taking time to be people focused.
Deciding to make business personal. Committed to transparent and timely communication.
Committed to get to know you, to match your talents, personality, and goals with the right opportunity and employer. Driven to find up and coming career challenges to share with you.
Have you decided it’s time to grow? Do you want some help? Could this be an up and coming move for you?
Experience Required for Your Success
Associates degree or equivalent business experience in a claims/customer service healthcare environment preferred
18-24 months experience as a Core Claims Processor or similar claims processing or customer service experience required
Experience with internal applications, such as Diamond, Macess, and Webchannels preferred
Understanding of managed care concepts and strong understanding of CPT, ICD-9 (ICD-10), HCPCS coding guidelines and CMS1500 & UB04 billing forms preferred
Strong problem solving and analytical skills with the ability to multi-task
What Do You Think?
Does your experience reflect what it takes to be successful in this role? Do the work and challenges get you excited about what's possible? Apply here.