Medical Claims Expert

7 days ago


Appleton, Wisconsin, United States Lucent Health Solutions LLC Full time
Job Summary

We are seeking a highly skilled Medical Claims Expert to join our team at Lucent Health Solutions LLC. This is an exciting opportunity for someone who is passionate about delivering exceptional customer service and has a strong understanding of medical claims processing.

About Lucent Health Solutions LLC

Lucent Health Solutions LLC combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. Our approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time.

Responsibilities
  • Process medical claims in a timely and accurate manner.
  • Provide written correspondence and verbal information to members, group contacts, agents, and healthcare providers.
  • Refer potential abuse, subrogation, and adjustment claims.
  • Perform necessary check run process and communicate check register information.
  • Provide responsive and professional customer service for assigned groups as well as other groups with Cypress as needed.
Requirements
  • 1-2 years previous claims experience.
  • Coding structures, CPT, HCPCS, Revenue codes, ICD 9/10, etc. experience or certification required.
  • Strong understanding of claims analyst process and procedures skills.
  • Thorough understanding of Self-Funding and Third-Party Administrating concepts.
  • Ability to navigate through and utilize various PC applications efficiently.
  • Strong organizational skills, problem solving, and decision-making skills required.
Salary and Benefits

The estimated salary for this position is $55,000 - $65,000 per year, depending on experience. We offer a competitive benefits package, including health insurance, retirement savings plan, and paid time off.



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