Medical Billing Specialist
Randstad is currently seeking a Medical Claims processor with experience in private medical plans not just medicaid or medicare. You will be responsible for adjudicating each claim from start to finish- prior and current experience is required to qualify for this role you'll also be responsible for handling incoming healthcare claims ensuring a high level of customer service and maximizing productivity by processing claims accurately, the first time. You'll put your skills and talents to work as you review, research, and process medical claims daily.
Review and research assigned claims by navigating multiple computer systems and platforms and accurately capturing the data/information necessary for processing (e.g. verify pricing, prior authorizations, applicable benefits)
Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/ certificates)
Working hours: 10:00 AM - 7:00 PM
Please SEND YOUR RESUME TO SAYDELIS.RODRIGUEZ@RANDSTADUSA.COM FOR CONSIDERATION WITH SUBJECT : CLAIMS
Must have 3-5 year claims Processing experience in both Professional and Institutional Claims.
Private insurance experience required.(Blue cross blue shield/cigna/etna etc)
Must be knowledgeable ICD9, ICD10. CPT, , APC rates, Modifiers, HICFA1500, UB04
EDI processing experience required.
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.