Claims Examiner (Medtech)

TL;DR

Claims Examiner (Medtech): Responsible for accurately processing medical claims in compliance with payer requirements and internal policies with an accent on accurate coding, data entry, and reimbursement methodologies. Focus on resolving claim discrepancies, requesting additional information, and maintaining detailed records of claims processing activities.

Location: Remote (US)

Salary: $17-18 per hour

Company

hirify.global LLC is a premier healthcare technology company revolutionizing medical claims processing as well as document management with unparalleled service, security, and efficiency.

What you will do

• Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies.
• Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing.
• Communicate with internal resources, and internal stakeholders to resolve claim discrepancies, request additional information, or clarify issues.
• Maintain accurate and detailed records of claims processing activities.
• Identify and escalate complex or unusual claims for further review or investigation.

Requirements

• At least 1-2 years of experience working closely with healthcare claims or in a claims processing/adjudication environment.
• Understanding of health claims processing/adjudication.
• Ability to perform basic to intermediate mathematical computation routines.
• Medical terminology strongly preferred.
• Understanding of ICD-9 & ICD-10.
• Basic MS office computer skills.
• Ability to work independently or within a team.
• Must be able to demonstrate sound decision-making skills.

Culture & Benefits

• Remote work offered.
• Equipment provided.
• Paid training to set you up for success.
• Comprehensive benefits: Medical, Dental, Vision, Life, HSA, 401(k).
• Paid Time Off (PTO).
• 7 paid holidays.
• A supportive team and a company that values internal growth.