Claims Examiner

Snelling Professional Services has been selected to locate a claims examiner for our client located in Springfield, NJ. The ideal candidate we are seeking will have a minimum of 1+ years experience.

 

The Claims Examiner will need to have knowledge and proficiency of the following:

 




Knowledge of Medical, Dental and Vision Claim Adjudication




Knowledge of CPT and ICD 9 coding, Medicare, HIPAA privacy laws




Levels of coverage provided under the Plan




Ability to determine PPO vs. NON-PPO providers




Knowledge of Claims Department procedures




All phases of claim batch preparation




Collaborating with other departments for proper processing of claims




Answer member and provider claims related to telephone inquiries




Direct telephone inquiries appropriately




Weekly monitoring of pended and medical review files




Organizational skills




Time Management skills




Customer Service Skills




Assistance with claim projects when requested




Other duties as assigned

 

Benefits:

 
35 Hour work week, after 35hours is time and a half
Company pays 100% of benefits.
Flex start time