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Medical Claims Coordinator

Date Posted: 7/25/2022

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Job Description

We are currently recruiting for Healthcare Inbound Customer Service Representatives for an IN OFFICE position located in the Clearwater area.  A local third party administrator of insurance is seeking an Insurance Claims Processor / Claims Adjuster to join their growing team.  This position will entail analyzing claims to determine the extent of the insurance carrier; interpreting contract benefits; receiving, organizing, and making daily use of information regarding benefits, contract coverage and policy decisions; coordinating daily workflow to match with check cycle days to meet all service guarantees; maintaining external contracts with policyholders, providers of service, agents, attorneys and other carriers as well as internal contacts with peers, management, and other support areas.   

**This is an In-Office position- NO REMOTE work available!**

Responsibilities and Duties: 

  • Examining/ Researching/ Performing and making decisions necessary to properly adjudicate claims and written inquiries
  • Interpreting contract benefits in accordance with specific claim processing guidelines 
  • Understanding the strategic concept of the business and being able to link these to the day-to-day business functions of claims processing
  • Minimal external contact wit providers/ agents/ policyholders

Qualifications:
  • Good Communication Skills; both written and oral 
  • Must have good PC Application skills and typing of at least 30WPM with accuracy and clarity 
  • Previous experience in Health/ Medicare/ Prescription Claims Adjudication experience is plus
  • Must be organized and have the ability to make good business decisions 
  • Excellent work ethic and reliability for your team 
  • Previous experience with UB/ Institutional (CMS-1450) and HCFA/ Professional (CMS-15000) Claims
  • Must be familiar with medical terminology, procedure and diagnosis codes preferred 
  • Must be familiar Qiclink software a plus
  • Must have the ability to calculate figures and co-insurance amounts 
  • Must have the ability to read and interpret EOB's
  • Must be capable to multi-task, prioritize, problem -solve and effectively adapt to a fast paced/ everchanging work environment in order to comply with service guarantees
  • Must be able to work independently and meet quality/ production standards
  • Must have clear understanding of the policy benefits and procedures within Claims unit
  • It is crucial that you are honest, as well as respectful for the company and its policies 
Pay: $18 - $20/ Hour
Temp to perm 

Hours: Must be capable of working between the hours of 8am - 6:15pm M-F 

All qualified candidates please apply or send your resume to angsmith@ultimatestaffing.com

We are an equal opportunity employer and make hiring decisions based on merit. Recruitment, hiring, training, and job assignments are made without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, or any other protected classification. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.
To apply please email your resume to angsmith@ultimatestaffing.com

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Job Snapshot

  • Employee Type:Full-Time
  • Location:Clearwater, FL
  • Job Type:Health Care
  • Experience:Not Specified
  • Education:Not Specified
  • Date Posted:7/25/2022
  • Contact: Angela Smith (727) 797-1260
  • Pay Range: $18.00 - $20.00 Hourly
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Job Reference: JO-2207-169680