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Healthcare Claims Coordinator

2 months ago

Detroit, Michigan, United States TekWissen ® Full time

Position: Insurance Claims Analyst

Location: Remote Work Available

Contract Duration: Long-term Engagement

Job Classification: Contractual Position

Work Arrangement: Hybrid (1 day onsite)

Compensation: $40 per hour on W2 basis

ROLE OVERVIEW:

  • The individual in this position will oversee the execution of benefit modifications for various client accounts, utilizing the claims processing system to ascertain and document requirements for system adjustments, conduct claims testing, validate system improvements, and implement necessary changes.

Key Skills and Experience Required:

  • Extensive background in medical and facility claims, with a solid grasp of the billing procedures, including ICD codes, procedure codes, and diagnosis codes.
  • In-depth understanding of medical claims benefits processing.
  • Comprehensive knowledge of medical, dental, vision, and hearing benefits.

Additional Required Skills and Experience:

  • Exceptional analytical and organizational abilities, capable of managing multiple tasks simultaneously.
  • Proficient in creating clear and concise documentation accessible to individuals without specialized knowledge.
  • Familiarity with Microsoft Office Suite (Word, Excel, Access).
  • Strong interpersonal skills, collaborative spirit, and a positive team-oriented attitude.

Preferred Skills and Experience:

  • Experience with NASCO 3270 Mainframe.
  • Knowledge of membership and eligibility processes.
  • Experience in BFM/BFAST benefit configuration, including analysis, testing, documentation, and quality assurance processes.
  • Working knowledge of SharePoint.

Educational Background and Certifications:

  • Bachelor's Degree in a relevant field is preferred.
  • Certification in Medical Billing/Coding is preferred.