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Medical Claims Processor - Experience Required
Glastonbury, CT 06033 US
Medical Claims - Healthcare Customer Service
Work for a growing Full-function 3rd Party Administrator that processes payments for thousands of individuals nationally. These volume transactions are associated with healthcare benefits, and medical payments that include deductibles and co-payments for medical and pharmaceutical claims.
Monday through Friday: 11:30am - 8:00pm with 2 days 9:30am to 6:00pm
Starting pay rate $22/hr
Resolve client health premiums and out of pocket medical expenses by reviewing medical documentation and looking at gaps in medical documentation or records that could help with payment guidelines.
A representative list of duties:
- Answer phones and respond to client inquiries related to payments made on their behalf.
- Make outgoing calls to clients, medical providers, insurance companies to resolve coding, payment, billing issues.
- Identify, research and resolve client issues.
- Ensure payment processing timeliness and accuracy are met.
- Send follow up letters approval and denial letters.
- Uses knowledge of Medicare, Medicaid and commercial insurance along with primary and secondary insurance claims.
- Process health and dental insurance premium payments for clients.
- Associate’s Degree preferred
- Experience with Medical Insurance including- Insurance follow up / Medical billing and payment / Billing resolution/ Insurance Claims
- Good understanding of Medicare, Medicaid, commercial insurance and secondary insurance
- Ability to read and understand missing Clinical Documentation, Clinical coding Enrollment; and Payment Terms related to insurance premiums and out of pocket expenses; Benefits Coordination with other insurance coverage.
- STRONG COMMUNICATION SKILLS–This is a highly interactive role . The chosen candidate will have experience with customer service, call center experience from an Insurance, billing or medical processing payment environment.
- Technology and Computer Skills: Proficiency with all MS Office applications (Excel, Word, Outlook, etc.) Billing and Insurance Software
This role is in a very nice office building that is easy to access with Free onsite parking.
Meet Your Recruiter
Recruiter, Healthcare Services
Tara Guglietta is a dedicated professional who has called Connecticut home for over a decade. She's a proud wife and a loving mother of three wonderful children. Tara's journey into the world of business and human resources began with a solid educational foundation.
Tara is a proud alumna of SUNY Brockport, where she earned her Bachelor's degree in Business Administration, with a minor in Mathematics. Her passion for business and analytics drove her academic pursuits, setting the stage for a successful career.
Upon graduation, Tara embarked on a fulfilling career in Human Resources and Recruiting, a field she's been committed to ever since. She has a wealth of experience in this domain, honing her skills and expertise with each passing year.
Since 2018, Tara has been an invaluable member of the J. Morrissey team, specializing in Healthcare Services. Her dedication and professionalism have made a significant impact on the company and the clients she serves.
Outside of her professional life, Tara's interests are diverse. She is a Certified Zumba Instructor and shares her passion for dance fitness by teaching two classes a week. Her commitment to staying active and promoting a healthy lifestyle shines through her Zumba instruction.
Interestingly, Tara's educational journey initially took her down a different path. She originally pursued a degree in Meteorology, demonstrating her curiosity about the natural world and the forces that govern it. While her career took a different turn, her love for learning and exploring new horizons remains a defining trait.
Tara Guglietta's story is one of dedication, versatility, and a lifelong commitment to personal and professional growth.