Description
This position is responsible for auditing health care insurance claims using client specific reimbursement policy, CPT coding guidelines and CMS criteria. You will research physician and facility claim payor history utilizing specialized claim systems while maintaining accurate documentation of activity.
Requirements
- Knowledge of all industry standard codes (CPT4, ICD-9, HCPCS and Revenue Codes)
- Minimum 2-3-year experience employed with a Health Insurance Claim Payer authorizing physician and facility claims with extensive review of hospital contracts
- Extensive review of hospital contracts
- Research and analytical skills are a must while adhering to quality and production standards
- Ability to learn new skills and react quickly to change
- Desire to exceed all production and quality standards
- Ability to work independently with minimal supervision
- Ability to understand and apply policy & plan concepts
- Ability to navigate in a Windows/Office environment
- Experience on the following claims processing systems is a plus: ACAS/RCE, HRP, FACETS, Proclaim, UNET Hospital Inpatient / Outpatient Claim processing experience
We Offer:
Competitive salary and bonus, Comprehensive health insurance benefits package, 401(k) Plan, Free Parking
This position is ideal for the person that excels in auditing health claims. Join a team that compensates you for innovative thinking and quality performance. Take your career to the next level by joining our growing company.
Job Type: Full-time
Benefits:
- 401(k) matching
- Dental insurance
- Flexible schedule
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
Weekly day range:
Education:
- High school or equivalent (Preferred)
Experience:
- Health claim processing: 1 year (Required)
Work Location: Hybrid remote in Berlin, CT 06037