Senior Claims Adjudicator
Company: NaphCare
Location: Birmingham
Posted on: May 27, 2023
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Job Description:
NaphCare, Inc. has an excellent opportunity for a Sr. Claims
Adjudicator (Claims Examiner Tier II, Claims Analyst Tier II) to
join our team at the Corporate Headquarters in Birmingham, Alabama.
The Sr. Claims Adjudicator will be responsible for reviewing
medical claims for accuracy and completeness, analyzing complex CCI
and CMS edits, making determinations on claims based on established
policies and procedures and processing claims for payment. The
ideal candidate will have strong knowledge and experience in
processing multiple claim types, including professional,
institutional and dental claims.Position Responsibilities:* Utilize
claims processing experience and working knowledge of Medicare and
Medicaid to effectively and efficiently process claims for payment
while adhering to internal deadlines.* Demonstrate ability to
handle daily workload with speed and accuracy.* Demonstrate a high
comfort level in working with large volumes of data.* Demonstrate
the ability to act as a mentor for others within team.* Demonstrate
a strong attention to detail and a commitment to customer service
throughout the claims process.* Additional duties and specific
projects as assigned.Position Requirements:* Associate Degree or
higher or equivalent work experience.* Minimum five years of recent
adjudication experience required.* An ability to define and
calculate Medicare and Medicaid is critical.* Working knowledge of
medical terminology, billing standards, and Medicare and Medicaid
methodologies.* Proficiency in Microsoft Office Suite and strong
written and verbal communication skills are also required.* CPC,
COC, CIC, or Specialty Medical Coding Certification preferred.This
is not a remote position at this time.Equal Opportunity Employer:
disability/veteranOutstanding Benefits Package:NaphCare offers
competitive benefits, including health, prescription, dental,
Employment Assistance Program (EAP) services, vision and 401(k).
NaphCare offers term life insurance at no cost to the employee and
provides PTO, paid holidays and an array of voluntary benefits.
Employees enrolled in our health insurance program receive
prescriptions free of charge when filled at our in-house pharmacy
or mail order program.The above statements are intended to describe
the general nature and level of work being performed by people
assigned to this job. They are not intended to be an exhaustive
list of all responsibilities, skills, efforts or working conditions
associated with a job
Keywords: NaphCare, Birmingham , Senior Claims Adjudicator, Other , Birmingham, Alabama
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