Medical Claims Examiner/Adjudicator

1 week ago

Aurora, United States Randstad Full time
Job DescriptionJob Description

Our client is a leading healthcare company with an urgent need for skilled Medical Claims Adjudicators local to Aurora, CO. This is a remote contract position, however, only candidates residing in Colorado within 2-hours of Aurora will be considered. Candidates must have 3+ years of true claims adjudication experience.

Details:

  • 3 month temporary assignment to start, could extend
  • Fully remote, equipment provided. Candidates must reside in Colorado within 1 hour of Aurora.
  • 8am-4:30pm MST, Monday-Friday
  • $21-23/hr

Responsibilities:

  • Candidates MUST live within 2 hours of Aurora, CO, and must reside in Colorado.
  • Must have minimum 3 years of claims processing adjudication experience (Claims Adjudication: payment determination is made to process the claim to a clean or denied status.)
  • Receives and adjudicates medical claims/bills for payment/denials.
  • Researches claims/bills for appropriate support documents and/or documentation.
  • Analyzes and adjusts data and benefits criteria for payment. Responds to and researches vendor and member problems, questions, or complaints.
  • Ensures claims/bills meet eligibility, benefit, and Medicare requirements.
  • Utilizes knowledge of organizational policies and procedures to ensure adherence to contractual agreements and non- contracted pricing arrangements along with compliance with government regulations.
  • Knowledge of medical terminology and international classification of Disease (ICD-10) and Current Procedure Terminology (CPT).
  • Skills in analysis, interpretation and application of procedures, practices and methods used in claims adjudication without direct supervision or oversight

Qualifications:

  • HS Diploma or equivalent
  • 3+ years of medical claims adjudication experience
  • ICD-10/CPT Code knowledge
  • Medical Terminology
Company DescriptionRandstad Staffing. We provide outsourcing, staffing, consulting, and workforce solutions within the areas of engineering, accounting and finance, healthcare, human resources, IT, legal, life sciences, manufacturing and logistics, office and administration, and sales and marketing.

We can’t wait to tell you all about itCompany DescriptionRandstad Staffing. We provide outsourcing, staffing, consulting, and workforce solutions within the areas of engineering, accounting and finance, healthcare, human resources, IT, legal, life sciences, manufacturing and logistics, office and administration, and sales and marketing. \r
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We can’t wait to tell you all about it

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