Medical Claims Examiner
Beacon Hill Staffing Group, LLC

Job Info

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Pay Rate $18/hr

Full Time / Monday - Friday

Previous Experience:

- 2-3 yrs medical claims experience

- Familiar with medicare EOBs

- CPTs processing - Medical codes

- Claim adjustments experience is helpful

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Position Summary

The Claim Examiner position is responsible for processing medical claims. Professional and institutional, MLTC, and DD claims for FIDA IDD and Medicaid plans in accordance to regulatory requirements and departmental policies and procedures.

Essential Functions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Process claims timely and accurately in full accordance of Medicare-Medicaid guidelines, as well as guidelines set forth by the Health Plan.
• Alert management promptly of any identified issues that impact quality and production.
• Consistently meet or exceed quality and production standards set forth by management.
• Identify and elevate potential Coordination of Benefits.
• Monitor and follow up on pending claim activity timely and accurately.
• Monitor and strategize claim inventory to ensure timelines of claim payments
• Provide phone support as needed for the Customer Service department queue
• Assist manager with ad-hoc reports and projects as needed.
• Assume responsibility for ad hoc projects or functions that promote the future success of the operation

Beacon Hill is an Equal Opportunity Employer that values the strength diversity brings to the workplace. Individuals with Disabilities and Protected Veterans are encouraged to apply.

If you would like to complete our voluntary self-identification form, please click here or copy and paste the following link into an open window in your browser: https://jobs.beaconhillstaffing.com/eeoc/

Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for reporting purposes only and will be kept separate from all other records.

Company Profile:

Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, a commitment to project completion and success and a passion for innovation, creativity and continuous improvement.

Our niche brands offer a complete suite of staffing services to emerging growth companies and the Fortune 500 across market sectors, career specialties/disciplines and industries. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs.

Learn more about Beacon Hill Staffing Group and our specialty divisions, Beacon Hill Associates, Beacon Hill Financial, Beacon Hill HR, Beacon Hill Legal, Beacon Hill Life Sciences and Beacon Hill Technologies by visiting www.beaconhillstaffing.com.

We look forward to working with you.

Beacon Hill. Employing the Future (TM)

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