Claims Examiner-Claims Processor
Claims Examiner-Claims Processor
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Salary Not Disclosed
1 Vacancy
Job Description
About us:
PayerFusion is a healthcare administrative solutions provider that offers health insurers and selffunded employers throughout the US and worldwide with innovative costeffective ways to process medical claims maintain high customer satisfaction levels and manage healthcare expenses.
The Opportunity:
PayerFusion is looking for an experienced Claims ExaminerClaims Processor to join our dynamic team. The successful candidate will help streamline our claims process and improve customer satisfaction. This is a great opportunity for an individual who enjoys working in a fastpaced teamoriented environment.
Job Responsibilities:
- Analyze and process claims in accordance with our clients policies and procedures.
- Identify and investigate inconsistent or fraudulent claims.
- Liaise with healthcare providers and policyholders regarding claims processing issues.
- Perform regular quality audits on completed claims.
- Document claim process and keep track of claim data for reporting and analysis.
Desired Qualifications:
- At least three years of experience in claims processing preferably in the health insurance sector.
- Knowledge of medical terminology and International Classification of Diseases (ICD) codes.
- Strong analytical skills and attention to detail.
- Excellent verbal and written communication skills.
- Proficiency in Microsoft Office Suite especially Excel and in claims processing software.
NicetoHaves:
- Experience with online claim submission platforms.
- Certified Professional Coder (CPC) certification.
- Knowledge of Foreign Language preferably Spanish.
- Experience with project management.
- Understanding of healthcare compliance and regulations.
Benefits:
- Health vision dental life and hospitalization insurance
- 401K with 4 match
- 12 Holidays Paid
- PTO
Employment Type
Full-Time
