- Review hospital claims and determine action needed to resolve pended claims
- Process and evaluate hospital claims manually or through claims work flow
- Validate information entered in hospital claims module (QNXT); determine the process or work flow needed to resolve discrepancies
- Finalize hospital claims by applying knowledge of eligibility, benefits, pre-authorization rules, contractual policy and operational procedures
- Review, finalize and respond to call tracking tickets in a timely manner to provider inquires
- Perform additional duties and special projects as assigned by management
- High School Diploma or GED required, some College or Degree preferred
- Minimum two (2) years experience entering and updating hospital or medical claims in a health insurance or benefits environment required
- Basic keyboarding skills required
- Strong knowledge of hospital claims, eligibility, benefits, and reauthorization rules; knowledge of health claims system (QNXT)
- Good knowledge of International Classification of Diseases (ICD-9, ICD-10) and Current Procedural Terminology (CPT) codes
- Demonstrated organizational, perform multiple priorities, and analytical skills with the ability to follow through on assignments
- Able to work well independently and in a team environment
- Ability to meet strict deadlines, work well under pressure and in a fast-paced environment
- Must meet performance standards including attendance and punctuality
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· Cash Claims Processor needs 3 years experience · Cash Claims Processor requires: · Working knowledge of mainframe computers and systems in general, ie: AS400. · Understands third party benefits and administration. · Minimum keystrokes per hour requirement of 10,000 with less ...
New York, New York, United States1 week ago
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· Cash Claims Processor needs 2+ years' experience · Cash Claims Processor requires: · Onsite · Job is in Brooklyn, NY · Monday 8:30 -5:00 · Tuesday 8:30 5:00 · Wednesday 8:30 5:00 · Thursday 8:30 4:30 · Friday 8:30 2:00 · Working knowledge of mainframe computers and systems ...
New York, New York, United States $38,000 - $72,000 (USD) per year5 days ago
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Join Us at TailorMed – Transforming Healthcare Affordability · Awarded Best in Class in Health Equity 2025 · At TailorMed, we're on a mission to eliminate barriers across the entire medication journey - from affordability to access and adherence. As a pioneering force in healthca ...
New York Full time12 hours ago
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Requisition #: · of openings: · 3 · Employment Type: · Full time · Position Status: · Permanent · Category: · Bargaining · Workplace Arrangement: · Hybrid · Fund: · 1199SEIU National Benefit Fund · Job Classification: · Non-Exempt · Responsibilities · Review hospital claims and d ...
New York, NY1 week ago
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We are seeking a detail-oriented and dependable Medical Claims Adjuster / Claims Specialist to join our team. · This role involves reviewing, processing, and entering a variety of claims including medical, · optical,dental,and Health Reimbursement Arrangement (HRA) reimbursement ...
Long Island City, NY1 month ago
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Requisition #: · # of openings: · 3 · Employment Type · Full time · Position Status · Permanent · Category · Bargaining · Workplace Arrangement · Hybrid · Fund · 1199SEIU National Benefit Fund · Job Classification · Non-Exempt · Responsibilities · Review hospital claims and deter ...
New York1 week ago
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The job of Claim Processor involves processing claims and obtaining deductions for backup. · Claim processing · Obtain and save deduction backup · Forward claims to responsible parties throughout the organization · ...
Bloomfield3 weeks ago
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We are seeking a highly motivated individual with strong attention to detail as well as the ability to understand and analyze customer debit memos.Strong written and verbal skills are a requirement as well as being extremely dependable, able to work in a team environment as well ...
Franklin Lakes1 month ago
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The job of Claims Processor requires high school diploma or equivalent experience in customer service or claims processing for at least 3 years. The candidate should have strong analytical skills attention to detail and ability to understand analyze customer debit memos. · High S ...
Franklin Lakes1 month ago
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This is an entry-level position as Medical Claims Processor for Russell Tobin's client in Paramus NJ reviewing and submitting medical claims using the practice's electronic health records (EHR) system · ...
Paramus1 month ago
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The Medical Claims Biller monitors insurance carrier adjudication of TeamVision medical claims for one or more doctor practices. · ...
Paramus3 weeks ago
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We are seeking an experienced Benefits Analyst to support our Health & Welfare Funds. · The ideal candidate will have strong claims-processing skills, excellent customer service abilities and high attention to detail.Process a variety of claims (Medical, Prescription, Hearing et ...
Springfield, NJ1 month ago
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The Medical Claims Biller is responsible for monitoring insurance carrier adjudication of TeamVision medical claims for one or more doctor practices.Utilize a practice EHR system and clearing house to review and submit claims to multiple medical insurance carriers Review open/unp ...
Paramus1 month ago
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Position : Claims Processor – Entry Level · Location : Franklin Lakes, NJ · Duration : 6 Months · Total Hours/week : 40.00 · 1st Shift · Client: Medical Device Company · Job Category: Customer Service · Level Of Experience: Entry Level · Employment Type: Contract on W2 (Need US C ...
Franklin Lakes, New Jersey, United States5 days ago
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This is a Medical Claims Coordinator/Processor position with Luxottica / Team Vision in Paramus, NJ. The job involves reviewing and submitting medical claims to insurance carriers, monitoring rejected claim reports, and coordinating with clearing houses. · Review and submit medic ...
Paramus3 weeks ago
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+This is a medical claims coordinator and processor position that involves reviewing and submitting medical claims to insurance carriers. The role requires strong organizational skills and the ability to multitask. · +Review and submit medical claims to insurance carriers using t ...
Paramus, NJ3 weeks ago
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· Insurance processor needs 2+ years experience · Insurance processor requires: · Working knowledge of mainframe computers and systems in general, ie: AS400. · Brooklyn, NY 11228 · Understands third party benefits and administration. · Minimum keystrokes per hour requ ...
New York, New York, United States5 days ago
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Expense Processor, Corporate Services · Position Overview: · The Expense Processor team conducts crucial review and audit of expense claims to ensure compliance, timely reimbursement, and effective customer service to Jefferies employees. · This position reports to the Head of T ...
New York1 week ago
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The job of Chief Clerk III is to retrieve voicemail messages, provide status updates, and maintain excel spreadsheets. They also data enter claims information, research eligibility system problems, and process mail. · Retrieve from DBL voicemail detailed messages for processors; ...
New York1 month ago
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Expense Processor, Corporate Services · Position Overview: · The Expense Processor team conducts crucial review and audit of expense claims to ensure compliance, timely reimbursement, and effective customer service to Jefferies employees. · This position reports to the Head of Tr ...
New York City Metropolitan Area1 week ago
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The Chief Clerk III will perform various administrative tasks including retrieving voicemails, preparing reports, and data entry. The role requires excellent keyboarding skills and knowledge of Microsoft Excel. Good communication skills are essential for this position. · ...
New York, NY1 month ago
Hospital Claims Processor V - New York - 1199SEIU Funds
Description
Job Title
Responsibilities
Qualifications
-
Claims Cash Processor
Only for registered members New York, New York, United States
-
Cash Claims Processor
Only for registered members New York, New York, United States
-
Copay Claims Processor
Full time Only for registered members New York
-
Hospital Claims Processor V
Only for registered members New York, NY
-
Medical Claims Processor
Only for registered members Long Island City, NY
-
Hospital Claims Processor V
Only for registered members New York
-
Claim Processor
Only for registered members Bloomfield
-
Claims Processor
Only for registered members Franklin Lakes
-
Claims Processor
Only for registered members Franklin Lakes
-
Medical Claims Processor
Only for registered members Paramus
-
Medical Claims Processor
Only for registered members Paramus
-
Medical Claims Processor
Only for registered members Springfield, NJ
-
Medical Claims Coordinator/Processor
Only for registered members Paramus
-
Claims Processor – Entry Level
Only for registered members Franklin Lakes, New Jersey, United States
-
Medical Claims Coordinator/Processor
Only for registered members Paramus
-
Medical Claims Coordinator/Processor
Only for registered members Paramus, NJ
-
Insurance Processor
Only for registered members New York, New York, United States
-
Expense Processor
Only for registered members New York
-
Chief Clerk III
Only for registered members New York
-
Expense Processor
Only for registered members New York City Metropolitan Area
-
Chief Clerk III
Only for registered members New York, NY