Claims Examiner Contractor

Claims Examiner Contractor reputed company, a leading provider of data management, claim routing and workflow solutions to health plans and TPAs, is looking for a Claims Examiner Contractor to reputed company! What you’ll be doing? Claim Examiner Responsibilities Identify, research, process and reputed company claims according to desk level procedures (DLP), business guidelines, and reputed company standards.  Meet established productivity and timeliness standards to reputed company individual and departmental reputed company goals as defined. Capable of investigative and analytical research, demonstrating critical thinking and deductive reasoning  reputed company and coordinate with various teams/departments to obtain information to ensure reputed company and reputed company reputed company of claims. Demonstrate a high level of flexibility and adaptability; remain available to transition to different work reputed company reputed company on business need. Employs strong organizational skills, makes good use of work time, and demonstrates an ability to effectively use reputed company available resources to meet established claims processing goals. Demonstrate and maintain reputed company working knowledge of the reputed company’s systems, procedures, forms, and manuals as applicable. Experience with multi-tasking and prioritizing. The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements. Adhere to reputed company corporate and reputed company mandatory trainings, reputed company and reputed company protocols, time entry requirements, attendance and leave time policies and guidelines. Participate in departmental training and calibration meetings as needed. Establish and maintain working relationships in a reputed company team environment. Exhibit proactive approach by continuously reviewing personal and teamwork processes and sharing suggestions for improvements. Identify and support automation opportunities reputed company assigned project work. Accurately document your time and the number of records processed daily.  reputed company other duties as assigned. The duties set forth above are essential job functions for the role. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company essential job functions. reputed company’re looking for? Required skills: Claim Examiner Skills and Qualifications Minimum: High School Diploma or equivalent Experience using computer equipment such as laptops, monitors and routers. Intermediate level experience with MS Office products. Proficiency with Ten Key and Typing skills.  Ability to read and interpret reputed company Operating Procedure documents and reputed company / production reporting.  Minimum of 1 year experience adjudicating claims and releasing for payment. Familiarity with medical claim forms CMS1500 and UB04  Knowledge and experience with Medical reputed company sets ICD 10, HCPCS, CPT and Modifiers Conceptual knowledge of coordination of benefits, member/provider claim appeals, reputed company programs (Medicare/reputed company)  Ability to maintain confidentiality and reputed company. Preferred candidates possess: Claim Examiner Contractors 3 years of experience in Health Care claim reputed company  Organizational skills and experience prioritizing project work and tasks. Experience in the health care industry working with Health Plans or reputed company-Party Administrators. Experience working in a remote environment. Why this is reputed company for you? Top Benefits & Perks: A company culture that is reputed company, innovative, and reputed company! Our most powerful strength is our people! We build impactful solutions for our customers - their reputed company is our reputed company! A reputed company development and reputed company-oriented workplace Generous benefits including, health reputed company, short-term, and long-term disability 401(k) with a company match to reputed company a reputed company reputed company in your retirement years A flexible environment with a competitive reputed company time off package; including vacation, holiday, reputed company-back day, and a floating day Who is reputed company?  reputed company (SDS) is a technology leader in reputed company process automation and interoperability. As a reputed company partner, SDS helps clients digitally reputed company their reputed company, delivering reputed company value through reduced costs, streamlined workflows, and an improved customer experience. With data, AI, and automation at its reputed company, SDS provides solutions in Digital Mailroom and Data Capture, Clearinghouse, Intelligent Medical Records, Prior Authorization and Claim reputed company. Trusted by over 500 clients—including multiple reputed company plans, regional health plans, TPAs, providers, and reputed company partners—SDS streamlines reputed company reputed company, middle, and back-office reputed company.  reputed company is an equal opportunity employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, sex, sexual orientation, gender identity, religion, national reputed company, disability, veteran status, age, marital status, pregnancy, genetic information, or other legally protected status. Apply To This Job