medical claims processor,

  • Premierehire in partnership with a large preventative and proactive health care provider and insurer is expanding their team to serve their growing client base. This client prides themselves in the quality of their work environment, the professional development opportunities they offer, and the career potential for motivated employees.

    Department: Operations Fitness
    Position: Temp to Hire
    Location: Carmel, IN
    Hourly Wage: $12.00/HR

    Job Summary
    The primary purpose of this position is to enter data from fitness and exercise center billing reports into the claims system.  This position is responsible for the accurate review, input and adjudication of claims in accordance with regulations, and contractual obligations of the organization.

    Responsibilities:
    • Reviews all incoming claims to verify necessary information.
    • Enters claims data and information
    • Maintains all required documentation of claims
    • Adjudicates claims in accordance with departmental policies, procedures, state and accreditation standards and other applicable rules.
    • Maintains production standard; processes an average of 36 claims per hour, with an accuracy rate of 98.5%. May start initial training for ERP requests
    • Provides backup for other examiners within the department.
    • Promotes a spirit of cooperation and understanding among all personnel.
    • Attends organizational meetings as required.
    • Adheres to organizational policies and procedures.
    • Maintains confidentiality of all claims files, claims reports, and claims related issues.

    Qualifications:  Education/Training/Experience/Licenses
    • High school diploma or equivalent.
    • 10 key and word processing; minimum 10,000 key strokes per hour required with 95% accuracy, (testing will be required). 
    • Experience processing claims preferred.
    • Proficient in MS Office.

    Skills:
    • Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
    • Ability to provide excellent customer for both internal and external customers.
    • Excellent listening and interpersonal communication skills
    • Ability to effectively organize, prioritize, multi-task and manage time.
    • Demonstrated accuracy and productivity in a changing environment with regular interruptions.
    • Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
    • Ability to exercise strict confidentiality in all matters.

    To Apply:

    Email your resume to: This email address is being protected from spambots. You need JavaScript enabled to view it. (preferably in MS Word) OR Text me at 760-815-2205

    Insert the job title 'Fitness Claims' in the subject line of your email with your resume.


    “We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

  • Premierehire in partnership with a large preventative and proactive health care provider and insurer is expanding their team to serve their growing client base. This client prides themselves in the quality of their work environment, the professional development opportunities they offer, and the career potential for motivated employees.

    Department: Operations Fitness
    Position: Temp to Hire
    Location: El Cajon, CA
    Hourly Wage: $12.00/HR

    Job Summary
    The primary purpose of this position is to enter data from fitness and exercise center billing reports into the claims processing system.  This position is responsible for the accurate review, input and adjudication of claims in accordance with regulations and contractual obligations of the organization.

    Responsibilities:
    • Reviews all incoming claims to verify necessary information
    • Enters claims data and information
    • Maintains all required documentation of claims processed and claims on hand.
    • Provides backup for other examiners within the department.
    • Promotes a spirit of cooperation and understanding among all personnel.
    • Attends organizational meetings as required.
    • Adheres to organizational policies and procedures.
    • Maintains confidentiality of all claims files, claims reports, and claims related issues.

    Qualifications: 
    • High school diploma or equivalent.
    • 10 key and word processing; minimum 10,000 key strokes per hour required with 95% accuracy. 
    • Experience processing claims preferred.
    • Proficient in MS Office.

    Skills:
    • Demonstrated ability to interact in a positive, respectful manner for cooperative working relationships.
    • Excellent customer service to meet the needs and expectations of both internal and external customers.
    • Excellent listening and interpersonal communication skills
    • Ability to effectively organize, prioritize, and manage time.
    • Demonstrated accuracy and productivity in an environment with regular interruptions.
    • Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
    • Ability to exercise strict confidentiality in all matters.

    To Apply:

    Email your resume to: This email address is being protected from spambots. You need JavaScript enabled to view it. (preferably in MS Word) OR Text me at 760-815-2205

    Insert the job title 'Fitness Claims' in the subject line of your email with your resume.


    “We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status”

     

  • Medical Billing Specialist opportunity in Sorrento Valley, CA with a health services company with career potential. The primary function of this position is to reconcile claims, including complex claims, for payment as per Explanation of Benefits from Health Plan Payors for 2-step accounts.

     

    Position:Contract up to 6 months

    Location: Sorrento Valley, CA

    Hourly Wage:$14.00/hr

    Hours: Monday thru Friday – 7:00am to 3:30pm

     

    Must Haves

    • High School diploma or equivalent
    • 2 to more years with claims processing, computer, typing, 10 key and telephone skills preferred
    • Knowledge of Microsoft Word and Excel helpful
    • 2 years or more of data entry experience (10-key 7000 keystrokes per hour – minimum / Alpha Numeric 11,600 keystrokes per hour - Minimum) and working knowledge of the computer keyboard.       
    • Familiarity with Managed Care, HMO, and PPO health plan provisions
    • Makes calls to Health Plans to check status of claims which may include payment or underpayment
    • Able to pass a comprehensible background check if an offer is extended and accepted
    • Able to pass a drug and alcohol screen

     

    To Apply:

    • Upload your resume to:www.premierehire.com
    • Email your resume to: gsalgadoThis email address is being protected from spambots. You need JavaScript enabled to view it. (preferably in MS Word)
    • Insert the job title in the subject line of your email with your resume.

     

    About Premierehire

    Premierehire in partnership with a large preventative and proactive health care provider and insurer is expanding their team to serve their growing client base. This client prides themselves in the quality of their work environment, the professional development opportunities they offer, and the career potential for motivated employees.

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