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Ossining

    Sr. Claims Examiner - Ossining, United States - Madison Approach

    Madison Approach
    Madison Approach Ossining, United States

    3 weeks ago

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    Description

    Job Description

    Position Title: Senior Claims Examiner

    Job Summary: Looking for a detail-oriented self-starter with a minimum of three years' experience in medical claims processing for a full-time Senior Claims Examiner role. This position involves reviewing and adjudicating medical, dental, vision, and prescription claims. It's a Temp to Permanent opportunity based in Ossining, NY. Schedule is Monday to Friday, 8:30am - 4:00pm, with an hourly rate of $27.00.

    Responsibilities:

    • Process various types of claims for client members.
    • Tackle complex claim issues and identify root causes.
    • Analyze insurance explanations of benefits for cost savings.
    • Follow up on incomplete claims and request additional information.
    • Manage insurance enrollments and government benefits.
    • Maintain a database with coverage information.
    • Supervise claims team in the absence of superiors.
    • Audit processed claims and assist with unit projects.

    Qualifications:

    • High school diploma or equivalent; some college is a plus.
    • Minimum of three years in medical claims processing.
    • Expertise in HIPAA guidelines, medical codes, and terminology.
    • Knowledge of insurance plans like Medicare, Medicaid, HMO's, PPO's.
    • Strong self-starter with excellent organizational skills.
    • Leadership, negotiation, and communication skills are important.
    • Excellent interpersonal and customer service skills.
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