04 Nov
Remote Healthcare Claims Tester
Maryland, Baltimore , 21201 Baltimore USA

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


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