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Medical Claims Processor - Experience Required

Glastonbury, CT

Posted: 09/20/2023 Employment Type: Temp to Hire Industry: Health Care Job Number: 10790 Salary / Pay Rate : $21.00-22.00 Per hour

Job Description

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

Job Responsibilities:

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.

Required Skills:
  • 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

Tara Guglietta
Recruiter, Healthcare Staffing Services

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