Empleos actuales relacionados con Claims Examiner - San Juan, San Juan - Aps Health Care Pr
-
Insurance Claims Examiner
hace 3 semanas
San Juan, San Juan, Puerto Rico Firma de Reclutamiento en PR A tiempo completoJob Summary:Firma de Reclutamiento en PR seeks a highly skilled Insurance Claims Examiner to join our team. As an Insurance Claims Examiner, you will be responsible for handling high volumes of work and meeting established deadlines.Key Responsibilities:Verify policies and handle claims.Prepare reports and claims.Manage computer systems and...
-
Insurance Claims Examiner
hace 2 días
San Juan, San Juan, Puerto Rico Firma de Reclutamiento en PR A tiempo completoCompensation for this role is estimated to be around $65,000 - $85,000 per year.About the PositionFirma de Reclutamiento en PR is seeking a highly skilled Insurance Claims Examiner to join our team. As an Insurance Claims Examiner, you will play a critical role in ensuring that insurance claims are processed efficiently and fairly.Job DescriptionThe...
-
Insurance Claims Examiner
hace 2 semanas
San Juan, San Juan, Puerto Rico Firma de Reclutamiento en PR A tiempo completoAbout the Role: We are seeking a skilled Insurance Claims Examiner to join our team at Firma de Reclutamiento en PR. As an Insurance Claims Examiner, you will be responsible for reviewing and analyzing insurance claims to ensure they are accurate and valid.Responsibilities: The successful candidate will have the following...
-
Insurance Claims Examiner
hace 3 semanas
San Juan, San Juan, Puerto Rico Busy Season Staffing Solutions A tiempo completoClaims Examiner Job DescriptionEvaluate and analyze insurance claims to determine validity and ensure fair payouts. Review reports prepared by external parties, such as medical professionals or contractors, to verify information.Key Responsibilities:1. Review insurance policy terms and conditions against claims received.2. Conduct on-site inspections or...
Claims Examiner
hace 1 mes
Aps Health Care Pr is seeking a skilled Claims Analyst to join our team. As a Claims Analyst, you will be responsible for processing claims in accordance with established policies and procedures.
Key Responsibilities:- Process claims utilizing data entry and adjudication, and execute claims' adjustments when needed.
- Maintain a thorough knowledge of provider contractual issues and summarize plan documents for each assigned account.
- Identify possible coordination of benefits (COB) coverage if applicable.
- Follow claim processing guidelines to obtain all necessary information for accurate and timely processing.
- Process routine claims adjustments either electronically or manually while maintaining daily productivity rating.
- Collaborate with duties related to the claim audit process, including claim analysis, site visits, document preparation, and proper file storage.
- Maintain overall quality, accuracy of financial, and procedure aspects of operation.
- Receive and process correspondence when needed.
- Collaborate with new hire training when needed.
- High School diploma.
- Degree in Data Entry or related preferred.
- Minimum 1 year of experience in a similar position or data entry.
- Knowledge of Microsoft Office, including Excel, Word, and PowerPoint.
- Knowledge of general claim processing.
- Knowledge of Medical terminology, CPT, and DSMV coding.
- Strong verbal and written communication skills.
- Strong analytical skills with demonstrated ability to problem solve.
- Consultative selling skills and experience with ability to translate customer needs to sales opportunities.
- Professional verbal and written communication skills, with the ability to clearly articulate thoughts and ideas.
- Organizational skills with the ability to handle multiple tasks and/or projects at one time.
- Time management skills with the ability to prioritize and schedule daily activities for the most efficient use of time.
- Problem solving skills with the ability to look for root causes and implement workable solutions.
- Interpersonal skills with the ability to work in a fast-paced environment and participate as an independent contributor with little supervision or as an active team member depending on the situation and needs.
