Insurance Claims Processor 3rd Party

3 weeks ago


Melville, New York, United States The Bachrach Group Full time
Job Overview

We are seeking a highly skilled Insurance Claims Processor to join our team at The Bachrach Group LTD. As a direct hire opportunity, this role requires prior experience in hospitals or professional billing.

  • Claims processing experience.
  • Payer regulations knowledge.
  • Insurance billing rules understanding.

The ideal candidate will have excellent analytical and communication skills, with the ability to perform follow-up activities on billed accounts, ensure contracted payment rates are received, and provide timely and quality follow-up.

Key responsibilities include:

  • Ensuring knowledge of payer regulations through educational sessions and self-educational activities.
  • Knowledge of Medicare/Medicaid governmental benefits and third-party insurance billing rules and regulations.
  • Follow-up of third-party balance due accounts.
  • Contacting third-party payers via website portals, telephone, and/or correspondence.
  • Verifying insurance coverage/benefits and following up on billed insurance claims.
  • Analyzing credit balances and processing timely refunds via payments and/or claim corrections.
  • Accurate primary and secondary submission of clean claims via the Epic System.
  • Posting lockbox and EFT payments (insurance and self-pay payments and denials).

Preferred education and experience include:

  • College degree.
  • 1-2 years of prior health care experience.
  • Computer proficiency.
  • HIPAA compliance.

The estimated salary for this position is $60,000 - $80,000 per year, depending on experience.



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