Employer Industry: Healthcare Services

Why consider this job opportunity:
- Salary up to $64,700.00
- Opportunity to earn bonuses tied to company and individual performance
- Comprehensive total rewards package focused on employee well-being
- Engage in a collaborative environment aimed at process improvement
- Chance to develop skills in claims processing and healthcare operations
- Supportive atmosphere that encourages personal and professional growth

What to Expect (Job Responsibilities):
- Resolve complex coordination of benefits (COB) issues through member information updates and claims adjustments
- Process and adjust a variety of claims accurately and timely, adhering to established guidelines
- Act as a technical resource for training and coaching within the team
- Identify and track claims payment errors to determine root causes and corrective actions
- Ensure compliance with HIPAA, state, and federal regulations in all tasks

What is Required (Qualifications):
- High School Diploma or equivalent
- Minimum of one (1) year of experience in a claims environment or related healthcare operations
- Knowledge of medical terminology, CPT, and ICD coding strongly preferred
- Proficiency in Microsoft Office Suite, including Word, Excel, and PowerPoint
- Strong written and verbal communication skills

How to Stand Out (Preferred Qualifications):
- Previous experience in an HMO or related industry
- Experience with Medicare/Medicaid dual eligible claims
- Familiarity with managed care organizations or related healthcare industries
- Strong background in Facets claims processing
- Ability to effectively coach and provide feedback

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