Medical Claims Examiner Trainee
2 weeks ago
* Learn to request information to complete or review claims using standard procedures and letters, and asks questions as needed.
* Must demonstrate ability to learn and grow with continuous improvement and ability to increase average daily claim production while maintaining accuracy and quality.
* Performs computations and processes claims independently up to the dollar threshold set by the trainer not to exceed the job classification maximum of $1,500.00.
* Learns to perform duties and prepare to become a Claims Examiner by meeting training objectives and expected production metrics.
* Communicates efficiently by telephone, in writing or in person with all personnel, members, providers, external vendors or others regarding claim benefit questions or information.
* Communicates with the Quality Assurance Supervisor in conjunction with their trainer as necessary to request and receive data on pending claims.
* Learns to apply procedures to third-party liability claim claims.
* Exercises professional judgment on daily tasks and seeks approval from supervisor or trainer when faced with new or unfamiliar tasks.
* Maintain a 10 business-day turnaround time on assigned claim responsibilities.
* Maintain and update a pending file with follow-ups on correspondence as required.
* Ability to meet production and quality goals on a consistent basis as outlined within training.
* Routes claims requiring review to the assigned Claim Adjuster Senior II.
* Demonstrates knowledge of assigned duties as well as the legacy and the recently migrated claims processing system.
* Perform other duties as assigned.
* Minimum qualifications:
Minimum qualifications:
* 6 months or more within a Claims Pre-Processor position Or
* 6 months in another position with field related experience.
* Working knowledge of basic office equipment.
* Positive interpersonal communications with internal personnel, external clients and vendors.
* Demonstrated ability to keep calm and positive within all communications.
* Proven ability to accurately and timely review and edit documents.
* Utilize computer, phone systems and reference materials to be able to effectively perform the essential functions of the position.
* Previous experience utilizing Microsoft office software.
* High school diploma or G.E.D
Job Type: Full-time
Pay: From $19.87 per hour
Expected hours: 40 per week
Benefits:
* 401(k)
* Dental insurance
* Health insurance
* Life insurance
* Paid time off
* Vision insurance
Schedule:
* Monday to Friday
Application Question(s):
* Do you have at least 1 year of medical/dental claims ?
* What state do you live in?
Work Location: In person
-
Nursing Assistant Trainee Mercer
3 days ago
Mercer, United States University of Pittsburgh Medical Center Full timeNow hiring a Nursing Assistant Trainee in Mercer, Pennsylvania. The Nursing Assistant Trainee under the direct supervision of the Nursing Assistant Instructor performs assigned tasks to meet the basic resident care needs. In addition, the Nursing Assistant Trainee performs non-resident related activities to ensure the effective operations of the nursing...
-
Plans Examiner/Building Inspector
4 months ago
Camano Island, United States Island County, WA Full timeSalary: See Position Description Location : Camano Island, WA Job Type: Full Time Regular Job Number: 2024-062 Department: Planning & Community Development Opening Date: 07/01/2024 Closing Date: Continuous Summary Employee in this position examines residential and commercial building plans and makes construction site inspections to assure that plans,...
-
Corrections Officer
2 days ago
Mercer, United States Commonwealth Of Pennsylvania Full timeTHE POSITION Are you looking for more than just a job, but the start of a successful career? If you have a strong dedication to public service and want to help keep the public safe, we encourage you to submit an application for the State Correctional Institution (SCI) at...
-
Senior Reimbursement Specialist
2 weeks ago
Staten Island, NY, United States AdaptHealth LLC Full timeAt AdaptHealth we offer full-service home medical equipment products and services to empower patients to live their best lives – out of the hospital and in their homes. If you are passionate about making a profound impact on the quality of patients' lives, please click to apply, we would love to hear from you. The PAP Specialist has a broad range of...
-
Investigator Trainee
3 weeks ago
Staten Island, New York, United States Ethos Risk Services Full timeJob OverviewEthos Risk Services is a leading insurance claims investigation and medical management company that provides better data for informed decision-making. We are at the forefront of innovation in our space, driven by a dynamic team passionate about delivering exceptional services to our customers.Job SummaryThis role involves conducting field...
-
SIU Investigator
4 weeks ago
Staten Island, New York, United States Allied Universal® Compliance and Investigations Full timeJob Title: SIU Investigator - Insurance Claims SpecialistAdvance your career in insurance claims with Allied Universal Compliance and Investigation Services. As a global leader in the industry, we offer dynamic opportunities for claim investigators, SIU investigators, and surveillance investigators. Our diverse and inclusive team is committed to innovation...
-
Insurance Claims Investigator
3 weeks ago
Staten Island, New York, United States Allied Universal Compliance and Investigations Full timeInsurance Claims Investigator - Fraud Detection SpecialistAre you ready to take your career to the next level in the exciting field of insurance claims investigation? Allied Universal Compliance and Investigations is seeking a highly skilled and detail-oriented Insurance Claims Investigator - Fraud Detection Specialist to join our team.About Allied...
-
Rental Management Trainee
4 weeks ago
Long Island City, NY, United States Ryder System Inc. Full timeJoin Ryder System Inc. as a Rental Management Trainee and embark on a challenging and rewarding career path. As a key member of our team, you will support the shop management process and assist in cost savings, customer retention, and metric-based initiatives.This role requires strong communication and problem-solving skills, as well as the ability to work...
-
Water Restoration Claims Administrator
4 weeks ago
Staten Island, New York, United States Roto-Rooter Full timeJob Title: Water Restoration Claims AdministratorNationally recognized service company Roto-Rooter seeks an experienced claims administrator to join our fast-growing water restoration team. The ideal candidate will have 3-5 years of experience in the water restoration or insurance industry, with excellent Xactimate software skills and the ability to build a...
-
Medical Practitioner
4 weeks ago
Staten Island, New York, United States Tottenville Medical Pavillion Pllc Full timeJob DescriptionWe are seeking a highly skilled Medical Practitioner to join our team at Tottenville Medical Pavillion Pllc. As a Clinical Specialist, you will be responsible for examining patients, collecting medical history, and making diagnoses. You will also be interpreting diagnostic tests, explaining results to patients, and prescribing therapy or...
-
Saint Paul Island, United States Southcentral Foundation Full timeCommunity Health Aide Trainee: Hiring Range $17.44 to $22.67 Pay Range $17.44 to $25.29 Community Health Aide Trainee I Hiring Range $20.19 to $26.25 Pay Range $20.19 to $29.27 Community Health Aide Trainee II Hiring Range $22.55 to $30.06 Pay Range $22.55 to $33.82 Community Health Aide Trainee III Hiring Range $25.81 to $34.42 Pay Range $25.81...
-
Medical Practitioner
4 weeks ago
Staten Island, New York, United States Tottenville Medical Pavillion Pllc Full timeTottenville Medical Pavillion Pllc is seeking a highly skilled Physician Assistant to join our team. As a Physician Assistant, you will be responsible for examining patients, collecting medical history, and making tentative diagnoses on minor and major issues. You will also be reading diagnostic tests and reports, interpreting data, and taking the time with...
-
Physical Medicine and Rehabilitation Doctor
3 weeks ago
Mercer Island, United States MRG Exams Full timeDescriptionMRG Exams West, a wholly owned subsidiary of MRG Exams, a leader and premier service provider of independent medical examinations is looking for Physical Medicine and Rehabilitation Provider to perform medical assessments on United States Veterans as part of the VA's disability benefits process.The Physical Medicine and Rehabilitation Provider...
-
Physical Medicine and Rehabilitation Doctor
2 months ago
Mercer Island, United States MRG Exams Full timeJob DescriptionJob DescriptionDescriptionMRG Exams West, a wholly owned subsidiary of MRG Exams, a leader and premier service provider of independent medical examinations is looking for Physical Medicine and Rehabilitation Provider to perform medical assessments on United States Veterans as part of the VA's disability benefits process.The Physical...
-
Medical Care Specialist
3 weeks ago
Staten Island, New York, United States Tottenville Medical Pavillion Pllc Full timeJob Title: Medical Care SpecialistJob Summary:We are seeking a skilled Medical Care Specialist to join our team at Tottenville Medical Pavillion Pllc. As a Medical Care Specialist, you will be responsible for examining patients, collecting medical history, and making diagnoses on minor and major issues. You will also be reading diagnostic tests and reports,...
-
Medical Care Specialist
3 weeks ago
Staten Island, New York, United States Tottenville Medical Pavillion Pllc Full timeJob SummaryWe are seeking a skilled Nurse Practitioner to provide high-quality patient care at Tottenville Medical Pavillion Pllc. As a key member of our healthcare team, you will be responsible for examining patients, collecting medical history, and making diagnoses. You will also interpret diagnostic tests, explain results to patients, and prescribe...
-
Front Desk Coordinator – Mental Health Clinic
2 months ago
Mercer Island, United States Grace MindCare Full timeJoin Our Team at Grace MindCare!At Grace MindCare, we are dedicated to providing exceptional mental health care through compassionate and innovative treatment solutions. Our supportive and collaborative environment fosters excellence in patient care and promotes the well-being of both our clients and team members. Join our team and help shape the future of...
-
Medical Practitioner
4 weeks ago
Staten Island, New York, United States Tottenville Medical Pavillion Pllc Full timeJob OverviewWe are seeking a highly skilled Physician Assistant to provide exceptional patient care and support to our medical team at Tottenville Medical Pavillion Pllc.Key ResponsibilitiesConduct thorough medical examinations, taking detailed patient histories and charting all medically relevant information.Interpret diagnostic test results, make informed...
-
Full Time General Practice Physician
6 months ago
Grand Island, United States Northeast Healthcare Recruitment Full timeFlexible Part Time OpportunityGeneral Medicine Physicians (1099) to perform Compensation and Pension Examinations on Veterans, to assist in their VA Benefits Claims. Great Supplemental Income Opportunity.Must be computer savvy and be able to work on their own personal laptop. Should have either experience with, or take it upon themselves to become...
-
Nuclear Operations Training Specialist
4 weeks ago
Taylors Island, Maryland, United States Constellation Energy Full timeAccelerate the Transition to a Carbon-Free FutureConstellation Energy is a leader in clean energy production, and we're committed to accelerating the transition to a carbon-free future. As a Nuclear Operations Training Specialist, you'll play a critical role in developing and implementing training programs that support our operations teams.Key...