Pembroke Pines, FL
Our client is a leading certified provider of cost containment and medical risk management solutions in the South Florida area. This organization has been a pioneer in the delivery of managed care and cost containment services to many of the world’s leading insurance and assistance companies while setting the industry standard for quality customer service, medical management, and competent claims administration
We are seeking a Claims Processor who will review and adjudicate inpatient and outpatient claims, verifying eligibility, approval of services, and accurate pricing.
- Completes accurate analysis of claim determination for payment or denial based on established rules and processes
- Monitors claim inventory of assigned accounts and ensures turnaround and productivity benchmarks are met
- Processes claims from returned pended claims reports and those containing claim edits
- Manually prices claims based on specific rates
- Other responsibilities as assigned
Company benefits often include:
- Company sponsored health, GAP, dental and vision insurance @ 100% employee coverage (select a lower plan and it helps to cover dependents as well)
- Company sponsored short term and long term disability
- Generous paid time off
- 401K with company contribution @ 4% after 1 year with the company
- Tuition reimbursement after 2 years
- Multi-cultural, family oriented environment
- The opportunity for internal growth within the company
Interested? Apply directly now or give us a call at (Dade: 305-595-3800 / Broward: 954-437-0070) Questions about this role or others? Email firstname.lastname@example.org
*CAREERXCHANGE® is an equal opportunity employer. We will present the most qualified candidates to our clients based on the skills required to perform the job. For additional opportunities please visit www.careerxchange.com.
- 1 year of medical claim billing experience with knowledge of CPT4 and ICD10 codes.
- Knowledge of medical and insurance industry terminology
- Working knowledge of third party and medical provider
- Knowledge of billing and payment procedures
- Typing speed of 45WPM
- Bi-lingual (ANY SECOND LANGUAGE)