What are the responsibilities and job description for the Claims Examiner-Claims Processor position at PayerFusion?
About us : PayerFusion is a healthcare administrative solutions provider that offers health insurers and self-funded employers throughout the US and worldwide with innovative, cost-effective ways to process medical claims, maintain high customer satisfaction levels, and manage healthcare expenses.The Opportunity : PayerFusion is looking for an experienced Claims Examiner-Claims Processor to join our dynamic team. The successful candidate will help streamline our claims process and improve customer satisfaction. This is a great opportunity for an individual who enjoys working in a fast-paced, team-oriented environment.Job Responsibilities :
- Analyze and process claims in accordance with our clients' policies and procedures.
- Identify and investigate inconsistent or fraudulent claims.
- Liaise with healthcare providers and policyholders regarding claims processing issues.
- Perform regular quality audits on completed claims.
- Document claim process and keep track of claim data for reporting and analysis.Desired Qualifications :
- At least three years of experience in claims processing, preferably in the health insurance sector.
- Knowledge of medical terminology and International Classification of Diseases (ICD) codes.
- Strong analytical skills and attention to detail.
- Excellent verbal and written communication skills.
- Proficiency in Microsoft Office Suite, especially Excel, and in claims processing software.Nice-to-Haves :
- Experience with online claim submission platforms.
- Certified Professional Coder (CPC) certification.
- Knowledge of Foreign Language, preferably Spanish.
- Experience with project management.
- Understanding of healthcare compliance and regulations.Benefits :
- Health, vision, dental, life and hospitalization insurance
- 401K with 4% match
- 12 Holidays Paid
