Claims Processor

Job Overview

Medical Associates Health Plans is looking for a Claims Processor to join our team!

The Position:
This position needs someone with strong dedication to excellent customer service that shines over the phone, through written correspondence, and with colleagues. On a daily basis, this person will utilize their professional oral and written communication skills along with their ability to collaborate successfully with a team. Additionally, a successful person in this role will be organized and efficient at multi-tasking, may have some prior claims processing experience, and be proficient at Microsoft Excel and typing.

Schedule/Hours: Monday - Friday between 8am - 5pm, 40 hours/week. This position includes full benefits!

Location: Position is located at Medical Associates Health Plans, 1605 Associates Drive.

Competitive pay with benefits package worth $20,000!

Full Benefits Include:

• Health Insurance and Dental Coverage
• 401k, Profit Sharing Plan
• Medical & Dependent Care Flex Spending Accounts
• Vacation Paid Time Off (accrue up to 14 days/year)
• Sick Paid Time/Short Term Disability
• Holiday Pay (six holidays)

What you'll be doing:

• Examine, process, calculate, and pay claims after verification of fee schedules and contract benefits in compliance with state laws, employer contracts, policies and procedures, and production standards established by the company.
• Assist Health Care Services and Subrogation Specialist to ensure timely resolution of claims pended for subrogation and medical authorization.
• Possess knowledge of all health plan benefit plans and provide interpretation to all constituents including potential members, brokers, members, providers, employers, and staff.
• Make appropriate adjustments to previously adjudicated claims.

Knowledge, Skills and Abilities:
Education - High school diploma or GED required.

Experience - One to three years of similar or related experience.

Other Skills - Familiar with Microsoft Office applications, particularly Word and Excel.

As a healthcare organization, we adhere to applicable CDC and OSHA guidelines regarding the use of masking and social distancing.