LISTING: 3 Experienced Temporary F/T HMO Medical Claims Examiners Needed in Oak Brook, IL For $20/hr
These are all temporary full-time Medical Claims Examiner Positions working Monday-Friday from (7:30am to 4:00pm) daily with a 30 minute lunch break.
You will be responsible for processing 100% HMO Medical Claims for payment within a timely manner with a minimum 98% accuracy rate.
You will be expected to process at least 100 medical claims per day utilizing the EZ-CAP Software.
You will be given the option to work from home temporarily due to the COVID-19 Pandemic until the business office in Oak Brook, Illinois is open for business.
- Process 100 HMO medical claims per day with a high level of accuracy.
- Analyze claims and approve or deny payment. Provide expertise on claims processing issues to co-workers and management.
- Approve or deny claims for payment by ensuring the payment is correct, verifying the proper authorizations were submitted, and resolving any system hold codes.
- Resolve reoccurring provider or member issues by identifying trends and recommending solutions to management.
- Capture COB savings by coordinating payments of claims between insurance companies when more than one insurance company is involved.
- Resolve claims issues received from the Customer Services department by researching claim situations and providing timely responses.
- Enhance department productivity by recommending improvements to work flow processes and organizational structure.
- Ensure the completeness and accuracy of Standard operating procedures by providing feedback to the department manager on procedures that require documentation or additional detail.
- Contribute to team effort by accomplishing the related goals and results as determined by the Claim Manager.
- Maintains all necessary levels of member/patient privacy in accordance with HIPAA standards.
- Perform related duties as required.
- Associate’s degree or equivalent experience required
- At least 2-3 years of relevant professional experience, including claims processing
- Knowledge of claims and processes in Commercial, Medicare, and Medicaid health plan/TPA
- Extensive knowledge of CPT 4, HCPCS and ICD-10 coding and Medical terminology
- Demonstrate excellent organizational, analytic and problem-solving skills
- Demonstrate effective verbal and written communication skills.
- Proficient in MS Office Applications and ability to learn department and job specific software systems.
- Demonstrate high attention to detail and a high degree of accuracy
- Able to switch priorities in a positive and effective manner when directed by Company leadership.
All applicants are required to complete an online assessment exam.
If you or anyone you know is interested, qualified and immediately available please e-mail an updated resume to us for immediate review and consideration.