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    Senior Claims Examiner - Ossining, NY, United States - Apex Placement & Consulting

    Apex Placement & Consulting
    Apex Placement & Consulting Ossining, NY, United States

    3 weeks ago

    Default job background
    Description
    Do you have experience as a medical claims examiner and looking for the next step in your career? Are you looking to work for a company that makes a difference in your community?

    APEX Placement and Consulting has partnered with a local company in Ossining, NY looking to add an experienced Senior Claims Examiner to their already amazing team This person will be responsible for the review and adjudication of medical, dental, vision and prescription claims. Sounds intriguing, right? Keeping reading to learn more

    What's in it for you:
    • 1st shift opportunity – Monday to Friday from 8:30am-4pm
    • Competitive hourly wage at $27/hr.
    • Contract to hire position - you'll be hired in by our client based on performance and business needs
    • Benefit package available once hired on with client
      • Medical, Dental, Vision
      • Life Insurance
      • EAP
    What your day will look like:
    • Process claims for society members including medical, dental, vision, and prescription.
    • Deal with complex claim issues and identifying root cause of problems
    • Understand and analyze insurance EOB's to ensure maximum cost savings from plans.
    • Requests additional information for incomplete claims and follow up with provider as necessary.
    • Handle insurance enrollments as well as Social Security and other government benefits.
    • Maintain database containing data on insurance, Social Security, and medical device coverage.
    • Supervise Claims Examiners in absence of Claims Supervisor and/or Director.
    • Audit claims processed by Claims Examiners and Claims Assistant.
    • Assist the Claims Supervisor with all unit initiatives including check runs, cost containment, and special projects.
    What we are looking for:
    • High school diploma or equivalent; some college preferred
    • 3+ years' experience in medical claims processing
    • Must have working knowledge, compliance and understanding of HIPAA guidelines, ICD-10, CPT, ADA, HCPCS codes, medical terminology and familiarity with various health claims and forms including HCFA/CMS-1500, UB-04, and ADA forms.
    • Knowledge and understanding of various medical and prescription drug insurance plans including Medicare, Medicaid, HMO's, PPO's, and Government Plans
    • Self-starter able to work in a highly accurate, independent and organized, efficient manner
    Sound like a match? Apply today to speak with one of our HR professionals

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