Senior Claims Adjudicator

NaphCare, Inc.; Birmingham (AL); On-site; USD 45,000 - 75,000; Full time

Job summary

An established industry player in medical technology is seeking a Senior Claims Adjudicator to join their Birmingham office. This role is pivotal in processing claims efficiently while ensuring adherence to Medicare and Medicaid standards. As part of a supportive and engaged team, you will enjoy competitive pay, excellent benefits, and opportunities for professional growth. The company prides itself on delivering high-quality healthcare to correctional facilities, and you will play a crucial role in maintaining their commitment to excellence. If you are detail-oriented and passionate about making a difference in healthcare, this is the perfect opportunity for you.

Benefits

Health, Dental & Vision Insurance

401K with Company Contribution

Tuition Assistance

Referral Bonuses

Free Continuing Education

Generous Paid Time Off

Employment Assistance Program

Term Life Insurance

Qualifications

• 5+ years of adjudication experience in claims processing.
• Strong knowledge of medical terminology and billing standards.
• Proficient in Microsoft Office Suite.

Responsibilities

• Process claims for payment adhering to internal deadlines.
• Handle large volumes of data with accuracy.
• Act as a mentor for team members.

Skills

Claims Processing

Medicare Knowledge

Medicaid Knowledge

Attention to Detail

Data Management

Customer Service

Microsoft Office Suite

Mentoring

Education

Associate Degree

CPC Certification

COC Certification

CIC Certification

Job description

Senior Claims Adjudicator

Location

US-AL-Birmingham

ID

2025-20870

Category

Accounting/Finance

Position Type

Full-Time

Overview

NaphCare is hiring an experienced Senior Claims Adjudicator just like youto join our team at our Corporate Office in Birmingham, AL.

NaphCare is a family owned, medical technology company that has been delivering high quality healthcare to correctional facilities across the nation for over 30 years. Come join our team of over 6000 employees and growing! NaphCare pays well, offers outstanding benefits, and has an incredibly engaged corporate support team to make sure you have what you need to be truly excellent at what you do.

NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare. We recognize that we serve a unique and diverse patient population, and our onsite teams take pride in bringing excellence in care to a population in great need. Be part of a world-class team of professionals who are revolutionizing correctional healthcare as you use our cutting-edge resources, including our award-winning electronic operating system.

NaphCare Benefits for Full-Time Employees Include:

Prescriptions free of charge through our health plan
• Health, dental & vision insurance that starts day one!
• Employment Assistance Program (EAP) services
• 401K and Roth with company contribution that starts day one!
• Tuition Assistance
• Referral bonuses
• On-site education
• Free Continuing Education!
• Term life insurance at no cost to the employee
• Generous paid time off & paid holidays

NaphCare has a partnership with NetCE that provides CEU/CME for our staff. NetCE uses a rigorous peer review process to ensure that all activities and content are up to date. This service streamlines continuing education for all NaphCare Employees to meet state specific requirements for maintaining licensing.

With NaphCare, you'll play a critical role in our continuing mission to be the leading provider of quality healthcare in the correctional industry. If you want a career that will make a difference, choose the company that is different.

We support your growth and internal promotion. Once hired, we encourage our employees to continue to seek opportunities for advancement and leadership.

Responsibilities

Responsibilities for Senior Claim Adjudicator:

• Utilize claims processing experience and working knowledge of Medicare and Medicaid to effectively and efficiently process claims for payment while adhering to internal deadlines.
• Demonstrate ability to handle daily workload with speed and accuracy.
• Demonstrate a high comfort level in working with large volumes of data.
• Demonstrate the ability to act as a mentor for others within team.
• Demonstrate a strong attention to detail and a commitment to customer service throughout the claims process.
• Additional duties and specific projects as assigned.

Qualifications

Qualifications for Senior Claim Adjudicator:

• Associate Degree or higher or equivalent work experience.
• Minimum five years of recent adjudication experience required.
• An ability to define and calculate Medicare and Medicaid is critical.
• Working knowledge of medical terminology, billing standards, and Medicare and Medicaid methodologies.
• Proficiency in Microsoft Office Suite and strong written and verbal communication skills are also required.
• CPC, COC, CIC, or Specialty Medical Coding Certification preferred.

We know you may have questions before applying. To speak to a recruiter directly, email your questions and/or resume to [e-mail] with the position and location you're interested in.

Equal Opportunity Employer: disability/veteran