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Independent Health
Independent Health
1001 – 5000 Darbinieki
H1B vīzas sponsorsApdrošināšanaVeselības apdrošināšanaVeselības aprūpe
Independent Health ir Ņujorkas štata rietumu galvenokārt strādājoša veselības apdrošināšanas organizācija un viena no pirmajām veselības uzturēšanas organizācijām (HMO) reģionā. Tā nodrošina apdrošināšanas segumu un saistītos pakalpojumus aptuveni 355 000 cilvēku, piedāvājot vairāk nekā 100 plānus, produktus un pakalpojumus. Tās darbība ietver komerciālo veselības apdrošināšanu, aptieku pabalstus, Medicare Advantage un pašfinansētus veselības plānus. Uzņēmums savu kultūru raksturo kā vērstu uz palīdzību biedriem un darbiniekiem, lai viņi varētu parādīt savas labākās spējas.
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Vakances uzņēmumā

Claims Adjudicator – Medical and Dental Claims

Process medical and dental claims for Nova Healthcare Administrators, reviewing payments, coding, benefits, and customer questions. This hybrid role requires onsite attendance in Williamsville as needed.

USAmerikas Savienotās ValstisNYŅujorka
19 $ / stunda
HibrīdiPilna slodzeJaunākais speciālistsGrāds nav nepieciešamsNepieciešamā Valoda: angļuVispārīgi

Apraksts

  • Assess and adjust medical and dental claims using established criteria and client plan documents.
  • Address client, member, and provider questions about claim status, benefit design, and payments alongside Customer Service Representatives.
  • Process facility, professional, member-submitted, pharmacy, and dental claim edits for in-network and out-of-network benefits.
  • Review vouchers and payment explanations to find and resolve claim issues.
  • Meet departmental targets for output, accuracy, policy and procedure knowledge, and timely processing.
  • Investigate policy, payment, and coding matters.
  • Keep knowledge of contracts, summary plan descriptions, and benefits up to date.
  • Apply critical thinking when processing claims.
  • Use systems and applications to find details specific to each claim.
  • Find, interpret, and apply resources to individual claim scenarios.
  • Spot and communicate opportunities to improve processes.
  • Organize and prioritize claim-processing work.
  • Work with other Independent Health departments to resolve claim payment problems.
  • Attend the Williamsville office when required.

Prasības

  • A high school diploma is required.
  • A medical office assistant certificate and/or college degree is preferred.
  • At least six months of medical claims processing or medical billing experience, customer service experience preferably in healthcare or social services, or an equivalent combination of experience.
  • Knowledge of medical billing procedures.
  • Knowledge of CPT and ICD-9 coding.
  • Knowledge of medical terminology.
  • Data entry proficiency and familiarity with Microsoft Office products.
  • Strong organizational skills, attention to detail, and follow-through.
  • Strong written, verbal, and interpersonal communication skills.
  • Ability to communicate effectively with internal and external customers.
  • Ability to work collaboratively.
  • Flexibility to work additional hours as needed.
  • Examples of demonstrating Nova’s Core 4: Act with Passion, Work Together, Be Accountable, and Build Trust.
  • Ability to meet departmental deadlines and turnaround times and comply with state and federal regulations.
  • Immigration or work visa sponsorship is not provided.

Priekšrocības

  • First-class perks and benefits.
  • Eligibility for scorecard incentives.
  • A full range of benefits.
  • Generous paid time off.
  • Hybrid work arrangement.

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USAmerikas Savienotās ValstisCTKonektikutaNJŅūdžersijaNYŅujorkaPAPensilvānija
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