Claims Abjudicator

A busy medical insurance company is in need of 5 Claims Adjudicators for a month long project!!
Claims Adjudicator - TEMP (ends 5/21) - $16-19 PAY - 5 NEEDED
Claim adjudicators who work in the health care industry or for health insurance companies are known as medical bill advocates. Their job is to determine the amount of money that will be paid on a medical claim after the policy holder's insurance benefits and deductibles have been considered.
- Reviews, evaluates and adjudicates claims not automatically adjudicated by the processing system according to productivity and quality standards. - Interprets and processes routine claims. - Reviews and analyzes data from system-generated reports for in-process claims in order to identify and resolve errors prior to final adjudication. - Alerts claims management to claims aging issues as well as provider billing problems. - Maintains current knowledge of members' benefits, policies/procedures, provider network development and contract issues, processing system issues, Massachusetts Medicaid regulations, as well as industry standards for claims adjudication.
Education: - High School degree or equivalent required. Preferred/Desirable: - Some college coursework preferred. Experience: - Two years or more years experience in managed care claims processing preferred. Preferred/Desirable: Certification or Conditions of Employment: - Pre-employment background check Competencies, Skills, and Attributes: - Working knowledge of medical terminology as well as CPT4, HCPCS and ICD9 coding sets and HIPAA regulations. - Knowledge of Microsoft Office and FACETS preferred. - Ability to maintain production level and quality goals. - Follow through on commitments and meets deadlines - Work is thorough, accurate, and effective. - Demonstrates ability to complete assigned work in a timely fashion. Working Conditions and Physical Effort: - Ability to work OT during peak periods.
Working hours: 8:30 - 5p
If you are interested in this role, please email your interested with an updated resume to this job posting directly or email to bobby,demarco@randstadusa.com
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

Salary: $16 - 19 per hour + none

Don't Be Fooled

The fraudster will send a check to the victim who has accepted a job. The check can be for multiple reasons such as signing bonus, supplies, etc. The victim will be instructed to deposit the check and use the money for any of these reasons and then instructed to send the remaining funds to the fraudster. The check will bounce and the victim is left responsible.

More Jobs

Telecommute Entry Level Personal Injury Protec...
Worcester, MA Ameriprise Financial, Inc.
Telecommuting Auto Damage Claims Estimator
Worcester, MA Snapsheet Inc.
Claims Resolutions Specialist, Fast Path Property
Danvers, MA Liberty Mutual Holding Company Inc.
Telecommuting Senior Trucking Claims Specialist
Worcester, MA IAT Insurance Group
Telecommuting Inside Home Claims Representative
Worcester, MA Ameriprise Financial, Inc.