Medical Claims Examiner

19 hours ago


King of Prussia, Pennsylvania, United States Patient First Full time
Job Title

Occupational Health Insurance Representative

">About the Role

We are seeking a highly skilled Occupational Health Insurance Representative to join our team at Patient First. In this role, you will be responsible for reviewing and addressing processed claims, researching eligibility of benefits, and maintaining daily workflow goals.

Key Responsibilities
  • Claim Review and Processing: Review and address processed claims to ensure proper payments are received according to payers' contracts.
  • Eligibility Research: Research Eligibility of Benefits (EOB) to verify correct payment and adjustments are posted to patient accounts.
  • Registration Correction and Refiling: Correct registrations on Workers' Compensation accounts and refile claims as necessary.
  • Trend Analysis and Issue Reporting: Effectively communicate trends or issues to the Occupational Health Operations Manager.
Requirements
  • Education and Experience: High school graduate or equivalent, three years of experience working in the healthcare field, preferably in a medical billing department.
  • Skills and Qualifications: Excellent analytical, written, and verbal communication skills, ability to prioritize, organize, and multi-task in a timely manner.
  • Technical Requirements: Proficient in Microsoft Excel, Outlook, and Word.
Compensation and Benefits

The estimated annual salary for this position is $60,000 - $80,000, depending on experience. Additional benefits include health insurance, retirement plan, and paid time off.



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