Experienced Claims Analyst
2 weeks ago
Company Overview:
PayerFusion Holdings LLC is a premier service organization dedicated to providing exceptional solutions as a licensed Third-Party Administrator. We are actively seeking talented and knowledgeable professionals who can exceed our clients' expectations. Our commitment to innovation ensures a unique experience for healthcare providers, distinguishing us within the sector.
Key Responsibilities:
- Manage and evaluate claims processing and examination, including hospital and physician claims
- Possess comprehensive expertise in hospital and physician billing, along with Medicare, Medicaid, and PPO claims oversight
- Demonstrate proficiency in understanding policy details, including deductibles and coinsurance
- Utilize skills in ICD coding, claims processing, CPT codes, and hospital coding
- Maintain familiarity with Medicare Advantage plans, capitation strategies, and risk assessment methodologies
Qualifications:
- Demonstrated experience in medical claims processing and adjudication
- Self-driven with a strong desire for professional growth and accountability
- Mandatory proficiency in Microsoft Excel
Employee Benefits:
- Comprehensive health, dental, vision, life, and hospital gap insurance
- Generous holiday leave and Paid Time Off
- 401K plan with employer matching contributions
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