Claims Processor

Portsmouth, NH 03801

Posted: 10/02/2018 Industry: Claims Administrator Job Number: 3409224
Specific Responsibilities Process Professional and Hospital claims manually within claiming system Process claims according to set guidelines for payment or denial Review corrected and appeal claims for timely filing, accuracy and completeness Price claims according to Medicare, Medicaid and custom fee schedules Data entry of CMS-1500 and UB04 claims into our claiming system Active participation in weekly staff meetings Communicate with supervisor on workload/issues/backlog. Provide customer support for a 1-800 line for vendor inquiries as needed. Understand and be able to use all systems Provide accurate, valid and complete information by using the right methods/tools Meet personal and team goals and metrics Work as a team member with all other staff Follow procedures, guidelines and policies Assist with other duties as assigned.Qualifications: Proficient in Microsoft applications; particularly Word, Outlook and Excel. Ability to take initiative, prioritize tasks and manage workflow to meet deadlines. Ability to interpret, comprehend and follow policies and plan provisions. Excellent interpersonal and customer service skills. Excellent oral and written communication skills Problem solving and analytical skills. Demonstrated typing skills and accuracy rate. Ability to work autonomously and within a team. Basic understanding of medical coding guidelines and medical terminology. Basic understanding of healthcare and claims concepts. Knowledge of electronic billing systems preferred.Required Experience: High School degree or equivalent. Position in a claims or healthcare environment.

Delsin Grubbs
Senior Recruiter

Delsin began working with The Panther Group in 2007. He left for a few years, then returned as a recruiter in 2013 after coaching high school football and winning a state championship with that team. He is father to a 14-year-old sophomore in high school.

Delsin loves all food, but eats sushi 2-3 times a week.

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