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HealthCare Claims Adjudicator/Claims Examiner

Imagenet LLC

HealthCare Claims Adjudicator/Claims Examiner

Tampa, FL
Full Time
Paid
  • Responsibilities

    Job Description

    Job Description

    Imagenet is a premier healthcare technology company that has taken medical claims processing and document management to new levels of service, security and efficiency. We are looking for Claims Examiners to join our rapidly growing team in Tampa. Experience is preferred but not necessary. Candidates with the right aptitude and desire to learn will be given the required training to be successful. We are excited for this limited opportunity to train candidates that have a phenomenal work ethic without the seasoned experience and want to learn a new trade that can be taken anywhere universally once you become a seasoned claims examiner. Our classes offer in-depth training of all industry standards, coding and metrics. Please apply if you exhibit the focus and desire to do great things!

    We offer a great benefit package, flexible hours, and remote work for self-disciplined candidates who can perform well under limited supervision. Imagenet offers unlimited opportunities for candidates looking for upward mobility. Our leaders are always promoted from within and there is not a minimum employment time frame if you qualify for promotions. We appreciate referrals and always look to reward employees who help us grow via qualified referrals.

    Must be local to Tampa, FL

    Do not apply if you are not local to Tampa

    Job Description

    · Analyze and adjudicate a variety of claim types to include facility, professional, inpatient and outpatient services

    · Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria

    · Review different lines of business to include Medicare, Medicaid and Commercial services adherence to the contracts and timeliness guidelines

    · Authorize claim payments within established limits; otherwise forward to Claims Manager

    · Potentially process refunds appeals, disputes and adjustments (when applicable);

    · Identify process improvement opportunities within the claim department and recommend system enhancements

    · Handles any additional responsibility which may be assigned

    Education :

    · High School Diploma or equivalent required

    Experience :

    · Preference for minimum of one-year experience working closely with healthcare claims or in a claims processing/adjudication environment; Open to training candidates without experience.

    Technical Skills / Knowledge:

    · 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

    · Time management skills

    · Written and verbal communication skills

    · Attention to detail

    · Must be able to demonstrate sound decision-making skills

    Salary: $16.00 - $20.00 per hour based on experience.

    Job Type: Full-time

    Benefits:

    • Dental insurance
    • Health insurance
    • Vision insurance
    • Performance Bonus
    • Referral Bonus

    Schedule:

    • 8 hour shift
    • Monday to Friday
    • Flexible schedule

    Work Location: Hybrid remote in Tampa, FL 33609