Medical Claims Examiner

hace 1 semana


La Florida, Chile HealthCare Support Staffing A tiempo completo

Are you an experienced **Medical Claims Examiner** looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you

**Daily Responsibilities of a **Medical Claims Examiner**:
Responsible for the execution of all Claims Management and Third Party Administrative (TPA) functions to support system-wide Domestic and International lines of businesses. Key responsibilities include the accurate audit, claim analysis, timely payer collections management and adjudication of medical claims. In addition to, maintaining, develop and administer the PNS Contract Management Process. Team Lead(s) back up for the Para-Claim Parathon solution management, to include analyzing claim data in order to identify anomalies, trends and discrepancies. Responsible for the physician claims appeal and reimbursement reconsideration process for all line of businesses. Supports Team Lead(s) and leadership in departmental process improvement initiatives. Supports department leaders and Team Lead during the payment and reconciliation process as needed.**
**Requirements for **Medical Claims Examiner**:

- At least 1 year of experience with medical claims, specifically 1500 and/or UB forms
- Strong background in Medical Insurance Billing and collections, coding, claims regulations, revenue cycle, provider contract management, operational support, and registration
- Must have a solid understanding of hospital operations, contractual analysis, FDA health regulations, HIPPA regulations, DRG guidelines, as well as possess exceptional administrative skills.

**Hours for this Position**:

- Monday through Friday either 8am to 4:30pm or 8:30am to 5pm

**Advantages of this**
**Medical Claims Examiner***:

- Competitive weekly pay starting at $21-23/hr, depends on relevant experience
- Contract assignment for 6-12 weeks
- Benefits offered, Medical, Dental, and Vision
- Fun and positive work environment

**Interested in being considered as** Medical Claims Examiner**:

- Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law_.


  • Claims Examiner

    hace 2 semanas


    La Florida, Chile UPCIC A tiempo completo

    It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Position Overview: This is the career level where employees are assigned responsibilities for performing a full range of duties at the full performance level in reviewing and evaluating routine to complex...


  • La Florida, Chile UPCIC A tiempo completo

    It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Position Overview: This is the career level where employees are assigned responsibilities for performing a full range of duties at the full performance level in reviewing and evaluating routine to complex...


  • La Florida, Chile UPCIC A tiempo completo

    Know your rights Inform yourself of your rights and responsibilities by reviewing the content provided in the list below. - Employment Eligibility (e-Verify): - English & Spanish - Right to work: - English / - Spanish It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to...


  • La Florida, Chile AAA The Auto Club Group A tiempo completo

    It’s a great time to join AAA The Auto Club Group! JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD **Job Type**: Full time Exempt/Non Exempt: Hourly **Job Description**: Florida APD Claim Representative I - The Auto Club Group- Sign on Bonus for Qualified Individuals- What you will do: (Primary Duties & Responsibilities)- The Auto Club Group is...

  • Appeals Specialist

    hace 2 semanas


    La Florida, Chile BCforward A tiempo completo

    Appeals Specialist **BCforward is currently seeking a highly motivated Appeals Specialist for an opportunity in Remote!** **Position Title**:Appeals Specialist** **Location**: Remote** **Anticipated Start Date**: 9/23/2024** **Expected Duration**:3+ Months of contract with possible extension** **Job Type**: [FULL TIME (>%3D30 HRS WEEKLY)], [CONTRACT],...

  • Field Adjuster

    hace 3 semanas


    La Florida, Chile UPCIC A tiempo completo

    It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. The Field Adjusters primary responsibility is to manage, investigate and resolve assigned property claims. This position is dedicated to providing customer service to policyholders by providing fair and...


  • La Florida, Chile BCforward A tiempo completo

    Member Risk Adjustment Coordinator I **BCForward is currently looking for Member Risk Adjustment Coordinator I**: - Remote** **Position Title: Member Risk Adjustment Coordinator I (Remote)** **Locations: REMOTE - FL (EST)** **Anticipated Start Date: ASAP** **Expected Duration: 6+ Months** **Job Type: Contract with possible extension** **Shift: 8 am - 5...

  • Field Adjuster

    hace 2 semanas


    La Florida, Chile UPCIC A tiempo completo

    It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. The Field Adjuster’s primary responsibility is to manage, investigate and resolve assigned property claims. This position is dedicated to providing customer service to policyholders by providing fair and...

  • Field Adjuster

    hace 3 semanas


    La Florida, Chile UPCIC A tiempo completo

    It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Position Overview The Field Adjuster’s primary responsibility is to manage, investigate and resolve assigned property claims. This position is dedicated to providing customer service to policyholders by...


  • La Florida, Chile BCforward A tiempo completo

    Insurance Verification Coordinator I **BC Forward is looking for **Insurance Verification Coordinator I (Remote)** **Position Title: Insurance Verification Coordinator I (Remote)** **Locations: Remote - EST/CST** **Anticipated Start Date: 9/22** **Expected Duration: 4 Months** **Job Type: Contract with possible extension** **Shift: 8a-9p (depends on the...

  • Specialist I

    hace 2 semanas


    La Florida, Chile AmerisourceBergen A tiempo completo

    - What you will be doing - ONSITE AT CLIENT HEALTH SYSTEM - PRIMARY DUTIES AND RESPONSIBILITIES:_ 1. Demonstrates the ability to fully and accurately utilize IndiCare and all its functionality for successful claims management. 2. Identifies and qualifies patients for patient assistance programs at assigned facilities. 5. Interfaces appropriately with PAP...

  • Corporate Representative

    hace 2 semanas


    La Florida, Chile UPCIC A tiempo completo

    It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Responsible for attending depositions, verify interrogatories & file review as well attend trial (When required) Duties and Responsibilities: - Attend depositions, verify interrogatories, attend trials...


  • La Florida, Chile Masonite A tiempo completo

    We heard you knock! Job Purpose: The Customer Service Representative is responsible for the execution of timely and accurate processing of customer quote orders and claims. Main Responsibilities: - Answer incoming customer phone calls in a professional manner while maintaining appropriate phone metrics and KPIs. - Follow up to ensure that customer issues...


  • La Florida, Chile BCforward A tiempo completo

    Insurance Verification Coordinator I **BCforward is currently seeking a highly motivated**Insurance Verification Coordinator I for an opportunity in Remote!** **Job Title: Insurance Verification Coordinator I** **Location: Remote** **Expected Duration: 2+ months** **Anticipated Start Date: 01/06/2025** **Shift time: 8AM- 9:PM M-F** **Pay-Rate: $17/Hr. on...


  • La Florida, Chile AmerisourceBergen A tiempo completo

    - What you will be doing - The Consulting Services division of AmerisourceBergen hires throughout the year at varying levels of experience and offers opportunities to work remotely with no centralized location to commute to. All US-based team members are considered for open roles regardless of their geographical location and time zone. Our commitment to...


  • La Florida, Chile Salesforce A tiempo completo

    **Job Category **:Products and Technology **Job Details**: **Are you inspired by the idea of helping the MuleSoft Healthcare and Life Sciences (HLS) organization thrive in the digital landscape? Do you love to learn about new technologies and show how they can lead to institutional innovation? Do you enjoy presenting at public events, publishing your ideas...