Claims Examiner

An established health services organization based in New York City has an immediate opening for a Claims Clerk – Customer Services. Our ambulatory care facilities are staffed with a wide range of health professionals to provide extensive medical and diagnostic services.

The Claims Examiner is responsible for medical claims processing on the MCO claim system. Other responsibilities will be claims data entry, claims adjustment, provider service phone inquiries, claims scanning reviews, and Accounts Receivable requests.

Position Qualifications:

· Good business acumen with a customer focus and service orientation

· Knowledge of core claims related coding such as CPT4, HCPCS, ICD10

· Knowledge of medical forms, medical coding, and medical policy pertaining to insurance claims

· Must meet and/or exceed qualitative and quantitative production standards

· Provide informational resource for other employees

· Strong communication (written/oral) skills

· Interact with physicians to answer claims related questions and work through adjustment requests

· Claims payment systems experience required

· Familiar with MS Office Suite

We offer a competitive salary including, but not limited to, the following benefits:

· Medical, Dental, Pharmacy and Vision health benefits at no cost to all benefits-eligible employees and their eligible dependents

· Paid Time Off (Vacation, Personal, Sick days, and 12 paid Holidays)

· 401(k) Plan

· Life Insurance

· Tuition Reimbursement

· Mental Health Coverage

· Legal Services Benefit

· Gym Membership Reimbursement

Short Term and Long Term Disability Benefits

Email resume. EOE

Job Type: Full-time

Pay: From $61,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Travel requirement:

• Travel

Work setting:

• In-person
• Office

Work Location: In person