Claims Examiner II/III

5 days ago


Toledo, Ohio, United States Innovative Management Systems Incorporated Full time
Job Title: Claims Examiner II/III

We are seeking a highly skilled Claims Examiner II/III to join our team at Innovative Management Systems Incorporated. This is a challenging and rewarding role that requires a strong understanding of Medicare claims processing and a keen eye for detail.

Key Responsibilities:
  • Accurately review and analyze professional claims for a managed service organization (MSO)
  • Work independently and multitask to make benefit determinations and calculations
  • Collaborate with other departments and providers to resolve claims-related issues
  • Identify and resolve root causes of claim payment errors
  • Generate reports to track and analyze claims data
Requirements:
  • High School diploma and equivalent work experience in the managed care industry
  • 3+ years of related claims processing experience in a managed care organization
  • Knowledge of Medicare rules and regulations
  • Excellent communication and interpersonal skills
  • Ability to work independently and as part of a team
What We Offer:
  • Competitive hourly wage: $24-$37 per hour
  • Benefits-eligible position with PTO, PSL, Holidays, 401(k), Flexible Spending Account, Work/Life Balance, and Unpaid Time Off
  • Opportunity to work with a dynamic and growing company

Please note that this is a non-exempt, full-time position with a typical office schedule of Monday-Friday, 8:30 am-5:30 pm. Travel may be required for check runs.



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