Healthcare Claims Adjudicator/possibility of Remote - Phoenix, United States - ImageNetLLC

ImageNetLLC

Verified Company

Phoenix, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

$500 HIRING BONUS AFTER 90 DAYS OF SUCCESSFUL
EMPLOYMENT

MUST BE LOCAL TO PHOENIX
This position is based in our Phoenix office. However, employees who consistently meet performance metrics are eligible for a flexible work arrangement that allows working from home.

To qualify, employees must:

Consistently meet or exceed all productivity and quality metrics for their role over a 3month period
Demonstrate the ability to collaborate effectively and maintain strong communication with team members while working remotely
Have no active performance improvement plans or disciplinary issues
Once the above criteria are met, the employee may submit a request to work from home up to 2 days per week. Approval will be at the manager's discretion based on business needs and the employee's proven performance.
Any decrease in productivity or engagement may result in the flexible arrangement being discontinued.
Analyze and adjudicate a variety of claim types to include facility, professional, inpatient and outpatient services
Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria
Review different lines of business to include Medicare, Medicaid and Commercial services adherence to the contracts and timeliness guidelines
Authorize claim payments within established limits; otherwise forward to Claims Manager
Potentially process refunds appeals, disputes and adjustments (when applicable)
Identify process improvement opportunities within the claim department and recommend system enhancements
Handles any additional responsibility which may be assigned

Education:
High School Diploma or equivalent required

Experience:

Preference for minimum of oneyear experience working closely with healthcare claims or in a claims processing/adjudication environment

Technical Skills / Knowledge:

Understanding of health claims processing/adjudication
Ability to perform basic to intermediate mathematical computation routines
Medical terminology strongly preferred
Understanding of ICD9 & ICD10
Basic MS office computer skills
Ability to work independently or within a team
Time management skills
Written and verbal communication skills
Attention to detail
Must be able to demonstrate sound decisionmaking skills

Salary:
$ $18.00 per hour based on experience.

**$500 bonus after 90 days of SUCESSFUL employment

Job Type:
Full-time

Benefits:

Dental insurance
Health insurance
Vision insurance
Performance Bonus
Referral Bonus
PTO

Schedule:

8 hour shift
Monday to Friday
Flexible schedule

Work Location:
Hybrid remote in Phoenix, AZ 85021

Ability to commute/relocate:

Phoenix, AZ 85021: Reliably commute or planning to relocate before starting work (required)

COMPANY OVERVIEW
Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide.

Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans' members and providers.

The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans' members and providers.

The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually.

The company has also developed an innovative workflow technology platform, JetStream_TM_, to help with traceability, governance and automation of claims operations for its clients.

Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly-owned global delivery center in the Philippines.

Imagenet LLC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.