Hybrid Medical Claims Examiner

Job DescriptionHybrid Temp to Hire F/T Medical Claims Examiners Needed in Chicago Near ChinatownOur client a busy and growing Non-For-Profit Union Health & Welfare Fund located in Chicago near Chinatown has immediate staffing needs for some experienced hybrid temporary to hire full-time Medical Claims Examiners. You will be responsible for processing 100+ medical claims per day for payment utilizing the Basys Software with a 98% accuracy rate. Pay rate starts at $21 and increases based on experience.You must be available to start group training on Tuesday, November 5th, 2024, which will be 30 days onsite at the office in Chicago Monday-Friday (9:00am to 5:00pm).After training on site for roughly 30 days you will be working a hybrid partially remote work schedule 2 days in the office and 3 days from home with flexible hours between the hours of Monday-Friday (8:00am to 5:00pm) for a total of 37.5 hours paid hours per week.Job ResponsibilitiesYou will be required to process 100+ both PPO and HMO medical claims per day with a 98% accuracy rate and to ensure that all of the necessary claim information is present. Review provider reconsiderations and reprocess the claim or generate letter(s) in response to the request. Process check-run cycles and check-run audits when assigned. Perform audits of auto-adjudicated claims when assigned. Identify and report system issues, test and troubleshoot system configuration, completing reports, and run other system tasks or reports as assigned. Monitor pending claims to ensure that unnecessary delays are avoided. Correspond to providers, members and external vendors via mail, email or phoneAttend and participate in various meetings, including monthly all staff meetings, department meetings, training sessions, etc. Create one-on-one (1:1) agendas with the Director of Health Plans & Medical Claims using the Purpose, Outcome and Process (POP) Model and keeping thorough notes for each meetingJob RequirementsA High School Diploma is required a college degree is preferred. At least 5 years of recent medical PPO and HMO claims processing experience. Knowledge and understanding of the healthcare industry, including basic medical claim processing, subrogation, ICD-10 Diagnosis Codes, CPT Procedures Coding, HCPC Codes, HCFA 1500, and UB-02 claim formsStrong understanding of plan documents and insurance policiesIntermediate Microsoft Office Proficiency in (Word, Excel, and Outlook) and the ability to type at least 40 WPM. If you or anyone you know is interested, qualified, and currently available for employment please send an updated resume to us for immediate review and consideration.Company DescriptionWe are employment specialists who have worked in heath care and managed care industry for over a total of 25 years. We staff temp, temp to hire, and direct hire placementsWe are employment specialists who have worked in heath care and managed care industry for over a total of 25 years. We staff temp, temp to hire, and direct hire placements