Claims Examiner (26-151)

Kent County Cmh Authority; Grand Rapids (MI); Remote; USD 30,000 - 40,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid holidays

PTO

Professional development

Tuition reimbursement

License reimbursement

Retirement plan

Employee Assistance Program

Life insurance

Disability insurance

Loan forgiveness programs

Job summary

Network180, the behavioral health authority for Kent County, is seeking a Claims Examiner to ensure accurate processing, adjustment, and payment of claims from our provider network. The role is based in Michigan as a remote position with in-person meetings as needed, 40 hours per week, Monday through Friday, 8:00 am to 5:00 pm.

The ideal candidate has strong medical billing and coding experience and knowledge of Medicaid/Medicare.

Qualifications

• High school diploma or GED and at least four (4) years of medical billing, coding, and/or claims processing experience; or an associate’s degree and two (2) years of experience.
• Advanced computer skills including word processing, spreadsheets, database management, and email.
• Knowledge of Medicaid, Medicare and third-party insurances.
• Skills and experience in analyzing information and preparing spreadsheets and reports.
• Ability to prioritize tasks and manage time effectively.
• Excellent communication skills, both verbally and written.
• Excellent problem-solving techniques.
• Lived experiences with mental illness/developmental disabilities/substance use disorders valued.

Responsibilities

• Responsible for accurate processing, adjustment and payment of claims submitted by Network180’s provider network.
• May participate in in-person or virtual job interviews.
• Review and resolve claim discrepancies and ensure timely payments.
• Maintain accurate documentation and reporting as required.

Skills

Medical billing/claims processing

Advanced computer skills

Medicaid/Medicare knowledge

Analytical skills

Time management

Communication skills

Problem solving

Lived experiences with mental illness

Education

High school diploma or GED

Associate degree in health information technology

Tools

Word processing

Spreadsheets

Database management

Email

Job description

Other Managed Care UAW-Hourly Grand Rapids, MI, US 1 Attachments

Position: Claims Examiner Req.#: 26-151 FTE: Full-time, non-exempt Unit: UAW Department/Location: Revenue Cycle Services Compensation: $21.99 - $29.15

The final job offer is based on several factors (internal equity, skills, education, experience, and credentials).

Attractive Benefits Package:

• Four health insurance plans
• 100% employer paid dental and vision insurance plans
• 13 paid holidays
• Generous PTO
• Professional development
• Tuition reimbursement
• Professional License reimbursement
• Defined contribution retirement plan
• Employee Assistance program
• Life and voluntary life insurance options
• Short and Long term disability
• Approved site for loan forgiveness (based on position and department): NHSC, STAR Loan Repayment, Behavioral Health Loan Repayment, MI Kids Now Loan Repayment and much more!

Network180 employees make a difference in people’s lives every day, making our community a better place to live. We are the behavioral health community organization responsible for the delivery of mental health, substance abuse treatment coordination, and developmental disabilities services for Kent County. We need individuals who are passionate about making a difference by helping others.

We are seeking a Claims Examiner responsible for accurate processing, adjustment and payment of claims submitted by Network180’s provider network.

This position is 40 hours a week, Monday through Friday, 8:00 am to 5:00 pm. There are no weekends, on-call, or holiday requirements for this position. This is s Michigan based remote position. Candidates must reside in the state of Michigan and be available to attend in-person meeting in Kent County, Michigan, as needed.

MINIMUM QUALIFICATIONS:

• High school diploma or GED and at least four (4) years of medical billing, coding, and/or claims processing experience; or associate’s degree in health information technology or related field and two (2) years of medical billing, coding, and/or claims processing experience.
• Advanced computer skills including word processing, spreadsheets, database management, and email.
• Knowledge of Medicaid, Medicare and third-party insurances.
• Skills and experience in analyzing information and preparing spreadsheets and reports.
• Ability to prioritize tasks and manage time in an effective and efficient manner.
• Excellent communication skills, both verbally and written.
• Excellent problem-solving techniques.
• Lived experiences with mental illness/developmental disabilities/substance use disorders valued.

Job interviews are being conducted in person or via the internet. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed on the job description are representative of the knowledge, skill, and/or ability required. For a detailed job description and responsibilities please review the job description. Network180 is an Equal Opportunity Employer. Network180 participates in E-Verify.

Network180 is a drug and alcohol-free workplace, which includes the prohibition of recreational marijuana use. Successful completion of a drug screen is part of our background check process.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Assistance with the application process may be requested through the Human Resources Department at 616 336-3909 or [e-mail] .

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.