Healthcare Claims Investigator
Location:
Wilkes-Barre , Pennsylvania
Posted:
January 11, 2017
Reference:
53084131
ADECCO IS CURRENTLY RECRUITING FOR HEALTHCARE CLAIMS INVESTIGATORS IN THE WILKES BARRE AREA!

***To be eligible for this position, you MUST have some type of previous insurance experience***

POSITION HIGHLIGHTS:

-Full-time, temp-to-hire opportunity!
-Monday-Friday 8:00am-4:30pm.
-$16.00 per hour to start with additional monthly performance based bonuses!!
-Eligible for permanent hire after 90 days
-Full benefits upon hire *see below for additional salary and benefit information
-$250 referral bonus!


JOB SUMMARY

Answers incoming and initiates outgoing calls providing customer service to a variety of clients. Responds to inquiries regarding the outpatient claims billing status in an accurate, timely and non-biased manner. Reviews/reconciles/completes calls, tasks and patient accounts within the respective financial class in a timely and accurate manner.


ESSENTIAL FUNCTIONS:


-Call payors and/or utilized website resources to determine current status of claims previously billed
-Research claim denials on behalf of clients, make determination on proper next step for claim resolution
-Update, correct, and rebill medical claims according to proper billing guidelines
-Completes system tasks assigned, including annual required trainings
-Provides assistance/resolution to client inquiries
-Uses appropriate systems for payment determination
-Supports and assists team members
-Maintain a current working knowledge of all healthcare related issues and regulations
-Prioritizes workload according to the needs/demands of the client.
-Documents response activities to patient claim inquiries following client guidelines and system tasks and notes
-Proficiency in desktop enterprise systems (e.g. Microsoft Excel, Microsoft Word and Microsoft PowerPoint)
-Full time position 40 hours per week


INTERACTIONS:

Must conduct oneself in a professional manner. Patient discussions may include but not be limited to past due health care claims and claims research, including but not limited to, contracts, partial pays and denials.



KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:

-Must be able to work in a fast pace environment and be able to adapt to change at any given time in the industry
-Must be articulate and detailed orientated
-Must have excellent organizational and communication skills
-PC literate including AR software, Microsoft Office with strength in Excel
-Must have knowledge of health care accounts receivable
-Efficient computer skills
-Flexibility in work planning
-Ability to handle calls in a fast paced call center environment
-Ability to handle irate callers in a professional manner
-Ability to work independently and as a team member


EDUCATION AND EXPERIENCE:

-High school diploma required
-Three years' work related experience in healthcare
-Two years' experience in a healthcare related field


WORKING CONDITIONS:

-Must be able to sit for extended periods of time
-Must be able to utilize/view a PC and/or monitor dealing with claims and billing


** Upon Permanent hire, salary decreased from $16 to $14 per hour. However, you will receive full benefits and have access and opportunities for employee incentives and bonuses. All Employee Benefits start on the first day of permanent employment:

-Monday through Friday role
-Health Insurance, including Dental & Vision
-Life & Disability Insurance
-Wellness Program
-15 PTO (paid time off) Days & 11 Paid Holidays
-401(k) with company match and100% Vested on Day 1
-Employee Stock Purchase Program


The Adecco Group is a global leader in HR services. Our group connects over 700,000 associates with our business clients each day through our 6,600 offices in over 70 countries and territories around the world. We offer employment opportunities at any stage in your professional career. Contact us today to discuss available contract and direct hire positions. Adecco Group offers benefits including Holiday, 401(k), Insurance Benefit Plans and free Self-Paced Online Training Courses.
Adecco Group is an Equal Opportunity Employer Minorities/Women/Veterans/Disabled





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