Medical Claims Examiner

  • Location
    Mesa, Arizona
  • Category
    Billing
  • Job reference:
    US_EN_7_842406_2797447
  • Job Type
    Contract/Temporary

Ajilon is working with a healthcare company hiring a Medical Claims Examiner paying $17.00-$19.00 per hour depending on experience. If you have previous medical claims experience, apply today!

 

Responsibilities:

  • Processing of professional and facility medical services claims by reviewing and inputting data into the claims payment system using standard policies, procedures and guidelines.
  • Must meet quality/accuracy standard of 95% and production standards of 100-125 claims/day.
  • Forward claims to appropriate departments for Med Review, Eligibility, etc.
  • Verification of coverage and contract interpretation.
  • Pursues and follows up on open and pended claims promptly and independently.
  • Researches and investigates claims with multiple coverage and complexity to determine if claim is payable in accordance with various policy provisions. If payable, determine eligible payee(s) and payment amounts. If not payable, develop detailed letter of explanation based on policy provisions and claim documents. 
  • Critical thinker who can maintain focus and stay on task with minimal supervision
  • Participates and practices principles of continuous quality improvement
  •  
    Requirements:

  • 2+ years of Medical Claims processing/examining experience. 
  • Must be comfortable with MANUAL claims process
  • High school diploma or equivalent
  • Proficient in Microsoft Office Suite
  •  

    If you meet the above requirements, apply today! For quicker consideration, please send a copy of your resume to ashton.hallan@ajilon.com 



    Equal Opportunity Employer/Veterans/Disabled

    To read our Candidate Privacy Information Statement, which explains how we will use your information, please

    The Company will consider qualified applicants with arrest and conviction records

    Please apply with your CV to:

    The Adecco Group North America family of brands has been named a 2019–2020 Great Place to Work®.

    Your search. Our support.

    When you work with us, we'll be by your side at every step of your search.

    Resume assistance

    Your resume needs to grab the attention of employers. We'll help yours stand out.

    Interview coaching

    The interview is your time to shine. With us, you'll be prepared and confident.

    Career advancement

    Keep your skills sharp and your career moving forward—that's what we do.

    Excellent benefits

    Health, dental, vision, 401k, work-life balance. You’ll get all the benefits you need.

    Similar Jobs

    Looking for something more?

    Send us your resume and we'll do the searching for you.

    Send Resume