Claims Processor

Garden City, NY 11530

Posted: 08/13/2019 Employment Type: Contract To Hire Job Category: Administrative/Support Job Number: 6539 Pay Rate: $17/hr - $20/hr

HumanHire is looking to hire a Claims Processor for a reputable third-party medical benefit administrator in Mineola and the zip code is 11501.   This is a full-time position and must have 2-3 years of knowledge of Medical Claims processing.  

 

Responsibilities:

 
  • Ability to analyze and process health insurance claims
  • Work as a team member to achieve service levels for daily claims entry.
  • Enter and process participant reimbursement requests daily in the claims processing system.
  • Review participants’ submitted material and determine if it meets applicable guidelines for appropriate reimbursement
  • Must be able to resolve and escalate participant inquiries
  • Participate in special projects and other duties as assigned.
  • Research and respond to Network inquiries
  • Document incoming correspondence and medical claims ie: subrogation, accident information

 

 

Requirements:

 
  • 2-3 years of experience in Claims Processing/Claim Adjudication environment.
  • Experience with payer platform, Javelina and/or VBA is a plus
  • Strong data entry and computer navigation skills.
  • Typing speed of at least 30 words per minute.
  • Capacity to rapidly learn new software and processes.
  • Proficiency in Microsoft Office products.
  • Good oral and written communications skills.
  • Able to work independently.
  • Good Analytical Skill
  • Excellent Observational Skill
  • Good Interpersonal Skill
  • Ability to comprehend and apply rules-based decision making.
  • Must be a fast learner, highly motivated, adaptable, flexible, self-sufficient and able to produce quality results in an evolving, fast paced environment.
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