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Claims Adjudicator
2 months ago
Miami Jewish Health is a leading provider of healthcare services for aging adults in the Southeast. We are seeking a skilled Claims Adjudicator to join our team.
Job SummaryThis position is responsible for adjudicating medical and non-medical provider claims, ensuring accurate capitation reimbursement from Medicaid and Medicare. The successful candidate will possess excellent analytical and communication skills, with the ability to work independently and as part of a team.
Key Responsibilities- Adjudicate medical and non-medical provider claims, ensuring accurate reimbursement from Medicaid and Medicare
- Process provider claims for expenses by service line, ensuring client enrollment for accurate capitation reimbursement
- Generate accruals for Accounting, including physician, outpatient, dental, labs, x-ray, ambulance, DG clinic, hospital, nursing home, home health services, ALF's, nursing homes, and pharmacy
- Prepare and submit monthly expense accruals to Accounting
- Participate in department meetings and in-services as necessary
- High school diploma or equivalent; Associates Degree Preferred
- Minimum two years of experience in claims adjudication for community service programs
- Knowledge of Windows, Microsoft Outlook, Excel, and Word
- Excellent analytical and communication skills
Miami Jewish Health offers a competitive compensation package, medical/dental/vision coverage, and a 403(b)-retirement savings plan for eligible full and part-time positions. We also offer free on-campus parking, an onsite fitness center, and more.
Miami Jewish Health is an equal employment opportunity employer and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
