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Claims Adjustment Specialist I
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- About NYC Health + Hospitals
- MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
- As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics.
- Ensure that the proper payment guidelines are applied to each claim by using the appropriate tools, processes, and procedures (e.g., claims processing P&P’s, grievance procedures, state mandates, CMS/Medicare/Medicaid guidelines, benefit plans, etc.)
- Remain current with changes/updates in claims processing, as well as updates to coding systems.
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