Hybrid Healthcare Claims Adjudicator - Growth & Benefits

Independent Health; Buffalo (NY); Hybride; USD 22 000 - 31 000; Plein temps

Avantages offerts par ce poste

Scorecard incentive

Paid time off

Benefits package

Résumé du poste

Independent Health is seeking a Claims Adjudicator for a hybrid on-site position at our Williamsville location. You will adjudicate and adjust medical and dental claims, respond to inquiries, and ensure accuracy and timely processing in collaboration with customer service.

The ideal candidate has a high school diploma with medical billing or claims experience, familiarity with CPT/ICD-9 coding, and strong data entry and Office skills.

Qualifications

• Six months of medical claims processing/billing experience; customer service in healthcare preferred.
• Knowledge of medical billing; CPT/ICD-9 coding and medical terminology.
• Proficiency with data entry and Microsoft Office products.
• Solid organizational skills with attention to detail and follow-through.
• Good written, verbal and interpersonal communication; ability to communicate with internal and external customers.
• Must be able to work collaboratively; flexible to work additional hours.
• Demonstrated alignment with Nova’s Core 4: Act with Passion, Work Together, Be Accountable, Build Trust.

Responsabilités

• Adjudicate claims per policy for facility, professional, member-submitted, pharmacy and dental edits.
• Review vouchers/explanations of payments to identify and resolve claims issues.
• Meet department performance measures for production, accuracy, knowledge, and timeliness.
• Research edits showing policy, payment or coding inconsistencies.
• Maintain current contracts, summary plan descriptions and benefit knowledge.
• Adhere to deadlines and regulatory requirements.
• Use critical thinking to process claims.
• Navigate systems to locate claim information.
• Read, interpret and apply information to claim scenarios.
• Identify opportunities for process improvements.
• Prioritize and manage claim workload efficiently.
• Communicate effectively with other departments to resolve payment issues.

Connaissances

Medical claims processing

CPT ICD-9 coding

Data entry

Microsoft Office

Organization

Communication

Teamwork

Core 4 principles

Formation

High school diploma

Medical office assistant certificate

College degree

Description du poste

Independent Health is seeking a Claims Adjudicator for a hybrid on-site position at our Williamsville location. You will adjudicate and adjust medical and dental claims, respond to inquiries, and ensure accuracy and timely processing in collaboration with customer service.

The ideal candidate has a high school diploma with medical billing or claims experience, familiarity with CPT/ICD-9 coding, and strong data entry and Office skills.