Medical Health Claims Examiner Processor

Medical Health Insurance Claims Examiner or Processor - South Akron - $13.00 to $14.00/hour

This position processes medical charges to ensure appropriate reimbursement in accordance with state fee schedules or usual and customary guidelines in non-fee states. Promotes and provides customer service. Processes medical charges to ensure appropriate reimbursement in accordance with state fee schedules or usual and customary guidelines in non-fee states.

Monday through Friday from 7:00 am to 4:00 pm. Pay Rate: $13.00 - $14.00

Job Description

• Processes first and third party casualty medical claims in accordance with company policy and applicable federal and state regulations. Excellent understanding of claims procedures, rules and guidelines, and all aspects of claims adjudication (ex. COB rules, multiple surgeries, lab/radiology, etc.)
• Audits bills for detection of possible fraud;
• Remains current on coding updates, practices and legislation for assigned state(s).
• 2
• Knowledge of all aspects of benefits claims processing and basic claims adjudication principles and procedures, medical terminology, Current Procedural Terminology (CPT) and International Classification of Diseases (ICD9)
• Maintains comprehensive understanding of the auditing system in order to recognize errors and notifies appropriate persons for error correction.
• Prepares and submits administrative reports as required.
• Recognizes appropriate diagnosis and procedure codes submitted by medical providers and selects or assigns, as needed, corrects codes for entry into the medical bill auditing system.
• Coordination of Benefits
• Delivers a positive customer service experience to all internal and external current customers. Performing customer service responsibilities for providers and members as needed.
• Other duties as assigned.

Qualifications

• Education: High school studies; some post high school course work preferred
• Experience: Two-years of medical health claims handling or processing experience required.
• Knowledge: General knowledge of insurance processing activities and operational functions. Familiarity with claims policies and procedures and medical terminology.
• Must have excellent interpersonal skills and ability to work in a team-oriented environment
• Strong oral and written communications
• Excellent attendance is required

All Candidates must pass a PrideStaff background check and drug screen, and must provide two professional job references.

Staffing Done Right!

PrideStaff has won multiple Best of Staffing Awards for our great relationships with candidates. Our candidates consistently rank us as one of the top staffing agencies in the country. Over the years, we have helped tens of thousands of people find outstanding career growth opportunities. At PrideStaff, we truly value people, and we are dedicated to getting to know you and advocating on your behalf with our network employers across the country. Our Recruiters will help guide you with career tools and resources. We are pleased to offer a comprehensive benefits package to our Field Associates that provides peace of mind as you live and work.

· Medical, Rx, and Wellness Benefits

· Dental and Vision Plan Options

· Short-term Disability

· 401(k) Retirement Plan

· Holiday Pay

Why PrideStaff?

Work with a Staffing Firm that works for you! PrideStaff can offer you a wide-range of rewarding career options. We help you find the job that best matches your skills, interests, and goals. With locally-owned offices throughout the country, PrideStaff gives you the inside track to great jobs with 3,000+ employers. You may be on a temporary assignment now, but you are not temporary to us! We want to be your life-long talent agent.

See what some of our Field Associates have to say:

“They don’t make you pay to search for jobs, they are searching for you"

"PrideStaff was able to find a job that fit me"

“Without them I wouldn’t have the position I have now"

Work with an agency committed to being your long term partner in staffing.

Work with PrideStaff!

Apply today by calling (330) 510-5700.

Or visit: www.pridestaff.com/akron for a list of this job and many others.

JOB ID: 288903