Claims Processor - Urgent

JOB QUALIFICATIONS:
- Bachelor’s degree in Business administration, Healthcare Management, Nursing, or a related field is preferred
- A diploma in medical, healthcare, or business-related fields may be considered
- 1-2 years of relevant experience in medical claims processing or administrative support in healthcare, hospitals, clinics, or insurance/HMO industries
- Familiarity with medical billing and reimbursement processes
- Experience working with HMO procedures and healthcare provider networks is a plus
- Attention to Details: Accurate and thorough in reviewing medical claims, documents, and codes
- Analytical Thinking: Ability to interpret policy coverage, medical reports, and supporting documents to identify discrepancies or irregularities
- Communication: Strong written and verbal communication skills to coordinate with hospitals, clinics, and policyholders
- Technical Proficiency: Proficient in medical claims processing systems, Microsoft Excel, MS Word, and email platforms
- Problem-solving: Capable of investigating claims issues and resolving them in a timely
and efficient manner
- Familiarity with ICD, CPT, and HCPCS codes and medical terminology.
- Knowledge of insurance guidelines, HMO processes, and regulatory compliance.
- Ability to multitask and work efficiently under time constraints.
- Excellent organizational and documentation skills.