Healthcare Claims Specialist
3 days ago
Job Summary: We are seeking an experienced Claims Review and Adjudication Professional to join our team at University Health. The successful candidate will be responsible for reviewing and analyzing claims, coordinating with providers, and resolving claim issues.
About the Company: University Health is a leading healthcare provider dedicated to delivering high-quality patient care and exceptional service. Our team is passionate about making a difference in the lives of our patients and communities.
Main Responsibilities:
- Review and analyze claims to ensure accuracy and compliance with regulatory requirements
- Coordinate with providers and internal stakeholders to resolve claim issues
- Perform analysis of provider appeals and document outcome determinations via correspondence
Requirements:
- Bachelor's degree in a related field or equivalent experience
- At least five years of experience in HMO, PPO, or ASO claim processing
- Thorough knowledge of medical terminology, ICD-9/CPT4 Coding, and general managed care principles
Benefits:
- A competitive salary range of $65,000-$85,000 per year
- A comprehensive benefits package, including health insurance, retirement savings, and paid time off
- The opportunity to work with a dynamic team of healthcare professionals
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