Medical Claims Specialist - Avondale, United States - RPO Inc

RPO Inc
RPO Inc
Verified Company
Avondale, United States

2 weeks ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Description

Title
:
Claims Liaison

Location
:

REMOTE:
- _can live anywhere in US as long as they can work AZ hours_

Duration
:6 months contract (Temp to hire)
Target Start Date (based on successful onboarding completion)
:6/17/2024

Shift
:
Anytime between 7:00 AM - 5:00 PM MST - 8 hours/day
Walk me through the day-to-day responsibilities of this the role and a description of the project:

  • Audit check run and send claims to the claims department for corrections.
  • Identify any system changes and work notify the Plan CIA Manager to ensure its implementation
  • Collaborate with the claims department to price pended claims correctly
  • Document, track and resolve all plan providers' claims projects
  • Collaborate with various business units to resolve claims issues to ensure prompt and accurate claims adjudication
  • Identify authorization issues and trends and research for potential configuration related work process changes
  • Analyze trends in claims processing issues and assist in identifying and quantifying issues and reviewing work processes
  • Identify potential and documented eligibility issues and notify applicable departments to resolve
  • Research the claims on various reports to determine if appropriate to move forward with recovery due to noncovered items being allowed, etc.
  • Run claims reports regularly through provider information systems
  • Research verbal and written providers' claims inquiries as needed
  • Experience with Researching and Analyzing healthcare claims
  • Strong Excel-Intermediate and above exp requiredpivot tables and vlooks are used frequently so they must have this
What previous job titles or background work well in this role?

  • Claims, Medical billing,

Required Skills/Experience/Education:

-
3+ years of RECENT Claims & Medical Billing Experience in a Managed Care environment
:

-
Strong Excel Skills
  • Intermediate and above experience required (pivot tables and vlook up):
-
Analytical Skills, Attention to detail, Strong Typing/Data Entry Skills 40 WPM, Strong Proficiency in Microsoft Office, experience with multiple screens, and Multitasking skills
:


  • High School Diploma or GED required.

Job Type:

Contract


Pay:
$25.00 per hour


Expected hours:
No less than 40 per week


Benefits:


  • 401(k)
  • 401(k)
matching

  • Dental insurance
  • Flexible schedule
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Schedule:

  • 8 hour shift
  • Weekends as needed

Work setting:

  • Remote

Experience:


  • Pivot tables: 3 years (required)
Microsoft Excel: 3 years (required)
Medical Claims: 3 years (required)

  • Medical billing: 3 years (required)

Work Location:
Remote
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