Claims Examiner (26-151)

Network180 - Kent County Community Mental Health; Oregon; Hybrid; USD 30,000 - 40,000; Full time

Benefits offered by this job

Four health insurance plans

100% employer paid dental and vision

13 paid holidays

Generous PTO

Professional development

Tuition reimbursement

Professional License reimbursement

Defined contribution retirement plan

Employee Assistance program

Life and voluntary life insurance

Short and Long term disability

Loan forgiveness programs

Job summary

Network180 is seeking a Claims Examiner to ensure accurate processing, adjustment, and payment of claims submitted by its provider network. The role is a full-time, remote position based in Michigan with in-person meetings as needed.

The ideal candidate has a background in medical billing or coding, knowledge of Medicaid/Medicare, and strong customer service and problem-solving skills. The position offers competitive compensation and a comprehensive benefits package.

Qualifications

• High school diploma or GED with 4 years of medical billing or claims processing, or an associate degree with 2 years.
• Advanced computer skills including word processing, spreadsheets, database management and email.
• Knowledge of Medicaid, Medicare and third-party insurances.
• Excellent communication and customer service skills; strong problem-solving.

Responsibilities

• Process, adjust, and pay claims for Network180's provider network.
• Ensure accuracy and timeliness of billing and reimbursements.
• Collaborate with providers and internal teams to resolve issues.
• Maintain documentation and compliance with regulatory requirements.

Education

Associate’s degree in health information technology or related field

High school diploma or GED

Job description

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 a 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.
• Excellent customer service skills.
• 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.

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.