Medical Claims Examiner
Imagenet is a premier healthcare technology company that has taken medical claims processing and document management to new levels of service, security and efficiency. Our primary focus is performing grass roots training to our successful talented employees and ensuring their ongoing experience with us is fulfilling and fun while getting the job done. We offer a great benefit package, flexible hours, and remote work for those who are self-disciplined with a solid work ethic. Our Team members are versatile and have opportunities abound for those that want upward mobility.
Our core business is helping our clients reduce costs and increase productivity by providing the resources of staff that are proud of their work product and enjoy a Team environment.
Must be local to Tampa, FL
Do not apply if you are not local to Tampa
Job Description
Monday-Friday
Flexible and desirable hours available
Pay is DOE
� Analyze and process a variety health claim forms; UB-04, CMS-1500 or ADA
� Follow claims adjudication process to assure that all claims are adjudicated in accordance with CMS rules and regulations
� Review Medicare, Medicaid and Commercial services for appropriateness of charges
� Authorize claim payments within established limits; otherwise forward to Claims Manager
� Process refunds and letters of dual coverage (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 :
� Minimum of one-year experience working closely with health claims or in a claims processing environment; required
Technical Skills / Knowledge:
� Understanding of health claims processing
� Ability to perform basic to intermediate mathematical computation routines
� Medical terminology strongly preferred
� Understanding of ICD-9 & ICD-10
� 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 decision-making skills
Job Type: Full-time
Pay: $14.00 - $17.00 per hour