About the role
Medical Associates Health Plans is looking for a Claims Processor to join our team!
The Position: On a daily basis, this person will utilize their professional oral and written communication skills along with their ability to collaborate successfully with a team. Additionally, a successful person in this role will be organized and efficient at multi-tasking, may have some prior claims processing experience, and be proficient at Microsoft Excel and typing.
Benefits Package Includes:
- Single or Family Health Insurance with discounted premium rates for wellness program participation. - 401k with immediate matching (50% on the dollar up to 7% of pay + additional annual Profit Sharing) - Flexible Paid Time Off Program (24 days off/year) - Medical and Dependent Care Flex Spending Accounts - Life insurance, Long Term Disability Coverage, Short Term Disability Coverage, Dental Insurance, etc.
What you'll be doing:
- Examine, process, calculate, and pay claims after verification of fee schedules and contract benefits in compliance with state laws, employer contracts, policies and procedures, and production standards established by the company. - Assist Health Care Services and Subrogation Specialist to ensure timely resolution of claims pended for subrogation and medical authorization. - Possess knowledge of all health plan benefit plans and provide interpretation to all constituents including potential members, brokers, members, providers, employers, and staff. - Make appropriate adjustments to previously adjudicated claims.
Knowledge, Skills and Abilities: Education - High school diploma or GED required.
Experience - One to three years of similar or related experience.
Other Skills - Familiar with Microsoft Office applications, particularly Word and Excel.
Text as published by Medical Associates. We don't edit postings; apply and ask questions on the employer's site.