MedImpact Healthcare Systems, Inc.
Claims Processor II
MedImpact Healthcare Systems, Inc., Honolulu, Hawaii, United States, 96814
Overview
Claims Processor II role at MedImpact Healthcare Systems, Inc. on-site in Honolulu, Hawaii. United States of America (Non-Exempt). This is a full-time non-exempt position with potential overtime; typical hours are 8:00am to 5:00pm, Monday through Friday. Salary: $17.92 - $22.85 - $27.78 per hour. Sponsorship: This position is not eligible for Sponsorship. Responsibilities
Accurate and timely processing of Physician, Facility, Dental, and Vision claims for multiple plan designs (traditional PPO, Reference Based Pricing, MEC). Adhere to Corporate and Departmental standards including production and quality goals. Interpret schedules of benefits and plan documents to apply accurate benefits to claims. Identify potential system or plan design issues that would impact correct adjudication of a claim. Communicate with the Management team on claim processing questions and issues. Interpret and apply internal policies and procedures for claims adjudication. Identify and resolve the root cause of claim processing and/or data entry errors. Adjust previously processed claims. Identify claim overpayments and log refunds. Data entry of CMS 1500, UB 04, and dental claims; research complex claim issues; assist in audit projects. Work under general supervision, with guidance ranging from close to minimal oversight based on skill and performance. Qualifications
Education and Experience: GED/HS Diploma and 1+ year experience or equivalent combination of education and experience. Computer Skills: Intermediate knowledge of MS Office (Word, Excel, PowerPoint, Outlook); experience with Windows-based database programs preferred; strong aptitude for new programs. Certificates, Licenses, Registrations: Certified Claims Professional (CCP), Medical Billing and Coding Certificate, or Certified Professional Coder (CPC) not required but highly preferred. Other Skills and Abilities: Dependable, punctual, good interpersonal and communication skills, ability to follow directions, teamwork, adherence to policies, initiative and commitment. Reasoning Ability: Ability to interpret various instructions and solve practical problems with limited standardization. Mathematical Skills: Ability to apply fractions, percentages, ratios, and proportions; basic arithmetic operations with money and measurements. Language Skills: Ability to read, understand, and communicate effectively in writing and verbally. Physical Demands and Work Environment: Standard office environment; ability to sit, stand, and lift up to 25 pounds; on-site presence required in Honolulu; remote work is not an option for this role. Benefits
Medical / Dental / Vision / Wellness Programs Paid Time Off / Company Paid Holidays Incentive Compensation 401K with Company match Life and Disability Insurance Tution Reimbursement Employee Referral Bonus Additional Information
Equal Opportunity Employer, Male/Female/Disabilities/Veterans.
#J-18808-Ljbffr
Claims Processor II role at MedImpact Healthcare Systems, Inc. on-site in Honolulu, Hawaii. United States of America (Non-Exempt). This is a full-time non-exempt position with potential overtime; typical hours are 8:00am to 5:00pm, Monday through Friday. Salary: $17.92 - $22.85 - $27.78 per hour. Sponsorship: This position is not eligible for Sponsorship. Responsibilities
Accurate and timely processing of Physician, Facility, Dental, and Vision claims for multiple plan designs (traditional PPO, Reference Based Pricing, MEC). Adhere to Corporate and Departmental standards including production and quality goals. Interpret schedules of benefits and plan documents to apply accurate benefits to claims. Identify potential system or plan design issues that would impact correct adjudication of a claim. Communicate with the Management team on claim processing questions and issues. Interpret and apply internal policies and procedures for claims adjudication. Identify and resolve the root cause of claim processing and/or data entry errors. Adjust previously processed claims. Identify claim overpayments and log refunds. Data entry of CMS 1500, UB 04, and dental claims; research complex claim issues; assist in audit projects. Work under general supervision, with guidance ranging from close to minimal oversight based on skill and performance. Qualifications
Education and Experience: GED/HS Diploma and 1+ year experience or equivalent combination of education and experience. Computer Skills: Intermediate knowledge of MS Office (Word, Excel, PowerPoint, Outlook); experience with Windows-based database programs preferred; strong aptitude for new programs. Certificates, Licenses, Registrations: Certified Claims Professional (CCP), Medical Billing and Coding Certificate, or Certified Professional Coder (CPC) not required but highly preferred. Other Skills and Abilities: Dependable, punctual, good interpersonal and communication skills, ability to follow directions, teamwork, adherence to policies, initiative and commitment. Reasoning Ability: Ability to interpret various instructions and solve practical problems with limited standardization. Mathematical Skills: Ability to apply fractions, percentages, ratios, and proportions; basic arithmetic operations with money and measurements. Language Skills: Ability to read, understand, and communicate effectively in writing and verbally. Physical Demands and Work Environment: Standard office environment; ability to sit, stand, and lift up to 25 pounds; on-site presence required in Honolulu; remote work is not an option for this role. Benefits
Medical / Dental / Vision / Wellness Programs Paid Time Off / Company Paid Holidays Incentive Compensation 401K with Company match Life and Disability Insurance Tution Reimbursement Employee Referral Bonus Additional Information
Equal Opportunity Employer, Male/Female/Disabilities/Veterans.
#J-18808-Ljbffr