100 Garden City Plaza, Suite 110 Garden City, NY 11530
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.
- 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
- 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.