This position is for a Claims Processor with a company located inMiami, FL.

Summary: Provide claim processing services for members, doctors, and clients as provided by the company's various plans and programs. Positions are assigned either to an In-Network Claims unit that handles claims for doctors, or an Out-of-Network Claims unit that reimburses patients when they go to a different provider.

Duties and Responsibilities: Effectively and efficiently process claims ranging from routine to complex situations. Evaluate claim data to pay correct claim benefit amounts according to the company's plans and programs. This requires in-depth knowledge of the following areas: Plans, products, and services. Processing transactions. Policies and procedures for claim payment. Accurate completion of necessary documentation, letters, and forms processing. Effectively maintain and support quality, productivity, and timeliness standards. Contact members or doctors as well as receive and respond to telephone calls as needed. Gathering information, processing claims, and written correspondence.

Education and Qualifications: Typically has the following skills or abilities: One to two years experience in a medical office, medical insurance provider, or related technical education with exposure to CPT, HCPC, and ICD-9 codes. General understanding of how medical claims forms and codes are used

Demonstrated ability to work independently with minimal supervision. Takes initiative to effectively carry out responsibilities. Familiarity with the terminology and nature of work performed in a medical claims unit. Skill to use multiple automated information systems to retrieve and verify data. Proficient in a Windows environment with word processing, spreadsheet application, and data entry. Effective written and verbal communication skills to include the ability to develop and respond clearly and accurately to inquiries. Preferred Skills: Experience managing claims in JIRA, or related software. Experience managing a shared inbox or fax number. Ability to manage daily audits of pre-payment claims.

LI-HYBRID

The compensation range for the role is listed below. Applicable salary ranges may differ across markets. Actual pay will be determined based on experience and other job-related factors permitted by law. As a part of the compensation package, this role may include eligible bonuses and commissions. For more information regarding iCare benefits, please click here. Salary Description $15 - $18

iCare is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to age, gender, race, color, religion, sex, national origin, gender identity, sexual orientation, disability, or protected veteran status.

SV Paymaster Corporation dba iCare Health Solutions

New Jobs

Claims Processor/Miami, FL/Hybrid