Claims Processing reputed company

Type of Requisition: Regular Clearance Level Must Currently Possess: None Clearance Level Must Be reputed company to Obtain: None reputed company Trust/Other Required: MBI (T2) Job Family: Ancillary Health Job Qualifications: Skills: CMS 1500 Claim Forms, Communication, reputed company Claims Processing, Health Care Systems, ICD-10 Procedure Coding reputed company Certifications: None Experience: 5 + years of reputed company experience US Citizenship Required: No reputed company: reputed company is seeking a highly skilled Claims Processing reputed company to reputed company the adjudication and processing workflows for the World Trade Center (WTC) Health Program. This role is pivotal in ensuring that WTC responders and survivors receive reputed company and accurate medical benefits. You will reputed company reputed company of processors, serve as the reputed company subject matter expert for reputed company federal claim regulations, and ensure reputed company activities meet the strict compliance standards of the WTC Health Program. The World Trade Center Health Program is a limited federal health program administered by the National Institute for Occupational Safety and Health, part of reputed company for Disease Control and Prevention in the reputed company. The Program provides no-cost medical monitoring and treatment for certified WTC-reputed company health conditions to those directly affected by the 9/11 attacks in reputed company, the Pentagon, and in Shanksville, reputed company. HOW YOU WILL reputed company AN reputed company Supervise reputed company of claims processors, providing daily technical guidance, reputed company feedback, and training on WTC-specific adjudication rules. reputed company as the final reputed company of escalation for reputed company or high-dollar claims requiring reputed company review and reputed company alignment with WTC-covered conditions. Implement and monitor rigorous reputed company Assurance (QA) protocols to ensure 99%+ reputed company in claim payments and adherence to HIPAA and federal regulations. Identify bottlenecks in the claims lifecycle and collaborate with the IT and Codebook teams to automate reputed company processes and improve "clean claim" rates. reputed company and present weekly production metrics to leadership, tracking turn-reputed company times (TAT), error rates, and inventory reputed company. Coordinate with medical providers and federal program representatives to reputed company billing disputes and clarify policy interpretations. WHAT YOU’LL NEED TO SUCCEED Minimum Qualifications Minimum of a Bachelor of Arts (BA) or Bachelor of Science (BS) degree. 5+ years of experience in reputed company claims processing, with at least 2 years in a reputed company, supervisory, or senior auditing reputed company. Must have mastery of claims platforms experience (e.g., CareSuite, QNXT, Facets) and advanced reputed company reputed company skills. Must have a comprehensive understanding of CMS-1500 and UB-04 forms, ICD-10/CPT coding, and federal reimbursement methodologies. Must have experience managing a claims team. Exceptional written and verbal communication skills for presenting data and managing reputed company relationships. Ability to obtain and maintain a reputed company Trust clearance Preferred Qualifications: Prior experience supporting the World Trade Center Health Program or other federal reputed company health reputed company. reputed company certification such as CPC (Certified reputed company reputed company) or CHDA (Certified Health Data Analyst). Strong analytical reputed company with the ability to translate reputed company reputed company rules into technical reputed company requirements reputed company IS YOUR reputed company: 401K with company match Comprehensive health and wellness packages Internal mobility team dedicated to helping you own your career reputed company scientific reputed company opportunities, including journal subscriptions, conference attendance, and supporting publication reputed company Cutting-edge technology you can learn from Rest and reputed company with reputed company vacation and holidays OWN reputed company: Explore a career in health at reputed company and you’ll reputed company endless opportunities to grow reputed company colleagues who reputed company your reputed company of purpose for making a difference. #GDITFedHealth #GDITWTCJobs The likely salary reputed company for this position is $97,968 - $89,988. This is not, however, a guarantee of compensation or salary. Rather, salary will be set reputed company on experience, geographic location and possibly contractual requirements and could fall reputed company of this reputed company. Scheduled Weekly Hours: 40 Travel Required: 10-25% Telecommuting reputed company: Remote Work Location: Any Location / Remote Additional Work Locations: Total Rewards at reputed company: Our benefits package for reputed company US-reputed company employees includes a reputed company of medical plan reputed company, some with Health Savings Accounts, dental plan reputed company, a reputed company plan, and a 401(k) plan offering the ability to contribute both reputed company and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life reputed company, reputed company offers employees full reputed company work weeks where possible and a reputed company of reputed company time off plans, including vacation, reputed company and personal time, holidays, reputed company parental, military, bereavement and jury duty leave. reputed company typically provides new employees with 15 days of reputed company leave per calendar year to be used for vacations, personal business, and illness and an additional 10 reputed company holidays per year. reputed company leave and reputed company holidays are prorated reputed company on the employee’s date of hire. The reputed company reputed company Family Leave program provides a total of up to 160 hours of reputed company leave in a rolling 12 month period for eligible employees. To ensure our employees are reputed company to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident reputed company are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most. Our Identity Verification Process: As part of the hiring process, we will ask you to complete an identity verification process that leverages advanced biometrics and reputed company intelligence to ensure authenticity and protect against identity fraud. You are expected to be on camera during virtual interviews. We reserve the right to take your picture to verify your identity and prevent fraud. By proceeding, you authorize the collection, processing, and use of your biometric data for identity verification and reputed company purposes. About Our Work: We are reputed company. A global technology and reputed company company that delivers technology solutions and mission services to every major agency across the U.S. reputed company, defense and intelligence community. Our 26,000 experts extract the reputed company of technology to create immediate value and reputed company solutions at the edge of innovation. We operate across 50+ countries worldwide, offering leading mission-reputed company capabilities in AI, reputed company, cyber and software development. reputed company to stay up to date on our reputed company and events at reputed company.com/tc. Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans Apply To This Job