Claims Examiner II/III

Job Description

We are hiring for the position of Claims Examiner II/III at Innovative Management Systems Incorporated. The ideal candidate will have at least 3 years of experience in claims processing within a managed care organization, possess in-depth knowledge of Medicare rules and regulations, and be proficient in analyzing professional claims accurately.

Position Specs:

• Non-Exempt
• Full-Time
• Benefits-Eligible: PTO, PSL, Holidays, 401(k), Flexible Spending Account, Work/Life Balance, Unpaid Time Off
• Schedule: Monday - Friday, with flexible hours between 8:30 am - 5:30 pm
• Salary Range: $24-$37 per hour, based on experience

Responsibilities:

• Identify authorizations and match them to claims
• Adjudicate claims accurately
• Ensure compliance with company and governmental guidelines
• Document claim resolutions and maintain professional behavior
• Collaborate with stakeholders for successful claim resolutions

Requirements:

• High School diploma with related work experience in managed care
• 3+ years of claims processing experience in managed care organizations
• Proficiency in Medicare rules, medical terminology, and HCFA 1500 forms
• Strong communication, organization, and multitasking skills
• Proficiency in Microsoft Office applications

Compensation:

$24-$37 per hour