Claims Examiner II
| Category: | Professional |
| Location: | Roseburg, OR 97470 |
| Pay: | $22.00 Hourly |
| Posted: | 4 days ago |
| Status: | Open |
Description
Claims Examiner II
Join a supportive, remote team processing Medicare claims with flexible hours, strong leadership, and competitive benefits.
Company Profile
- This growing company provides third party Administration Services, processing health care claims for the last 30 years.
What's in it for you?
Elwood Professional associates are eligible for a comprehensive and competitive benefits package plus an exclusive savings program, including:
- Medical/Vision/Dental/Rx plans
- Holiday Pay
- Teladoc (online care)
- Referral Bonus Incentive
- And More!
Claims Examiner II Details:
Contract to Hire position- $
22.00 / hour First Shift
- Evaluate and adjudicate standard and non-standard claims based on department and CMS guidelines
- Maintain appropriate inventory levels for assigned clients
- Effectively analyze and interpret provider contracts
- Communicate with clients and internal departments to resolve claim-related issues and obtain additional information as needed
- Maintain clear, concise, and accurate documentation of all claims processing activities and decisions within the claims processing department
- Meet or exceed departmental production and quality standards
- Assist with adjustment projects as needed
- Adhere to strict confidentiality and security protocols, including HIPAA guidelines, and when handling all protected health information (PHI)
- Participate in training and stay informed on changes in healthcare regulations, policies, and industry standards
Claims Examiner II Qualifications:
- 3-5 years of experience in a Medicare claims adjudication environment
- Experience in PACE or Medicare Advantage is preferred
- Experience in Plexis Claims Manager is strongly preferred
- Advanced understanding of CMS guidelines
- Strong knowledge of CPT, ICD-10, and HCPCS coding
- Detail-oriented with strong analytical skills
- Ability to work independently
- Effective written and verbal communication skills
- Excellent organizational and time management skills
- Proficient in Microsoft Office Suite (Outlook, Word, and Excel)
- Pre-employment drug screen is required as a condition of employment
We are an Equal Opportunity Employer and celebrate diversity at all levels of our organization.
How to Apply:
Email, call, or text us today! Feel free to apply online at www.elwoodjobs.com!
Oliver Bergen
3025 Washington Blvd.
Ogden, UT 84401
(801) 781-2310 ext.
oliver.bergen@elwoodprofessional.com
Qualifications
*See above for qualifications
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