Medical Claims Examiner
3 days ago
We are seeking a highly skilled Medical Claims Processor to join our team at Imagenet. As a Medical Claims Processor, you will play a critical role in ensuring the accurate and efficient processing of medical claims in compliance with payer requirements and internal policies.
Key Responsibilities:- Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies.
- Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing.
- Communicate with internal resources and stakeholders to resolve claim discrepancies, request additional information, or clarify issues.
- Maintain accurate and detailed records of claims processing activities.
- Process claims end-to-end, identifying and escalating complex or unusual claims for further review or investigation.
- Consistently meet or exceed productivity and quality metrics for the role.
- Demonstrate the ability to collaborate effectively and maintain strong communication with team members while working remotely.
- Have no active performance improvement plans or disciplinary issues.
At Imagenet, we strive to provide flexibility where possible to employees who have demonstrated success in their role. This policy is subject to ongoing review and may be updated or discontinued based on business requirements.
We are an equal employment opportunity employer and prohibit 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.
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Injury Claims Examiner
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