Job Details

Are you a meticulous and experienced professional with a keen eye for detail? We are seeking a Medical Claims Processor to join our team. In this remote position, you will play a key role in the payment and denial of medical claims, ensuring accuracy and compliance with established guidelines.

Position Overview

This is a 5-month contract with the possibility of an extension and the opportunity to apply for permanent positions. You will be responsible for the adjudication of medical claims and bills, which involves analyzing data, applying benefit criteria, and ensuring all documentation meets contractual and governmental requirements.

Top Daily Responsibilities

• Adjudicate medical claims/bills for payment or denial based on contractual agreements and medical regulations.
• Verify claims/bills meet eligibility, benefit, and Medicare requirements.
• Research and respond to questions and complaints from vendors and members.

Required Skills & Experience

• A minimum of 3 years of claims processing adjudication experience REQUIRED! Specifically, experience with payment determination, not just billing.
• Knowledge of medical terminology and coding systems, including ICD-10 and CPT.
• The ability to analyze and interpret procedures and practices related to claims adjudication with minimal supervision.
• Basic PC skills and a working knowledge of Microsoft Word.

Job Details

• Schedule: Monday - Friday, 8:00 AM to 4:30 PM.
• Location: 100% remote. You may be required to go to the office at 2500 S. Havana St., Aurora, CO 80014, to pick up equipment.