Remote Healthcare Claims Tester

Zachary Piper Solutions, LLC - Remote Healthcare Claims Tester

Piper Companies is currently actively recruiting for a Healthcare Claims Specialist to work fully remote for a leading Vision care organization. The Healthcare Claims Specialist will work alongside the Implementation and IT teams to ensure that all information is accurately recorded. Responsibilities for the Healthcare Claims Specialist

• Participate in corporate projects to implement system upgrades, changes in procedures, and benefits accurately and efficiently
• Provides claims support for new group implementation
• Review and reprocess any claims adjusted from retroactive configuration changes
• Run user acceptance testing once enhancements to the system are implemented
• Coordinate provider check generation with report validation and resolution of voided check files
• Assist other departments with claims related issues related to check tracers and EOP/EOB generation
• Coordinate work with other departments to ensure testing is completed timely and accurately
• Identify system issues, business requirements, and/or enhancements

Requirements for the Healthcare Claims Specialist

• Minimum of 5 years relevant work experience in managed healthcare
• Understanding and knowledge of claims processing and adjudication
• Knowledge of medical terminology, ICD-9, ICD-10 and CPT-4 coding and managed care claims administration

Compensation for the Healthcare Claims Specialist

• $55 - 60k / yr based on relevant years of experience
• Full Benefits: Health, Dental, Vision, and 401k

Keywords : ICD-9, ICD-10, CPT-4, coding, claims, audit, specialist, healthcare, health, EOP, EOB, group implementation, implementation, provider, health provider, claims processing, claims support, dental, vision, 401k, competitive salary