Senior Claims Adjudicator
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What you'll do
- Utilize claims processing experience and working knowledge of Medicare and Medicaid to effectively and efficiently process claims for payment while adhering to internal deadlines.
- Demonstrate ability to handle daily workload with speed and accuracy.
- Demonstrate a high comfort level in working with large volumes of data.
- Demonstrate the ability to act as a mentor for others within team.
- Demonstrate a strong attention to detail and a commitment to customer service throughout the claims process.
- Additional duties and specific projects as assigned.
What they're looking for
- Associate Degree or higher or equivalent work experience.
- Minimum five years of recent adjudication experience required.
- An ability to define and calculate Medicare and Medicaid is critical.
- Working knowledge of medical terminology, billing standards, and Medicare and Medicaid methodologies.
- Proficiency in Microsoft Office Suite and strong written and verbal communication skills are also required.
Nice to have
- CPC, COC, CIC, or Specialty Medical Coding Certification preferred.
Summarised by NextRaise from the employer’s description, which follows in full below.
Full description from employer
Overview
NaphCare is hiring an experienced Senior Claims Adjudicator just like you to join our team at our Corporate Office in Birmingham, AL This is an on-site position.
NaphCare is a family owned, medical technology company that has been delivering high quality healthcare to correctional facilities across the nation for over 36 years. Come join our team of over 7000 employees and growing! NaphCare pays well, offers outstanding benefits, and has an incredibly engaged corporate support team to make sure you have what you need to be truly excellent at what you do.
NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare. We recognize that we serve a unique and diverse patient population, and our onsite teams take pride in bringing excellence in care to a population in great need. Be part of a world-class team of professionals who are revolutionizing correctional healthcare as you use our cutting-edge resources, including our award-winning electronic operating system.
NaphCare Benefits for Full-Time Employees Include:
- Prescriptions free of charge through our health plan
- Health, dental & vision insurance that starts day one!
- Employment Assistance Program (EAP) services
- 401K and Roth with company contribution that starts day one!
- Tuition Assistance
- Referral bonuses
- On-site education
- Free Continuing Education!
- Term life insurance at no cost to the employee
- Generous paid time off & paid holidays
NaphCare has a partnership with NetCE that provides CEU/CME for our staff. NetCE uses a rigorous peer review process to ensure that all activities and content are up to date. This service streamlines continuing education for all NaphCare Employees to meet state specific requirements for maintaining licensing.
With NaphCare, you'll play a critical role in our continuing mission to be the leading provider of quality healthcare in the correctional industry. If you want a career that will make a difference, choose the company that is different.
We support your growth and internal promotion. Once hired, we encourage our employees to continue to seek opportunities for advancement and leadership.
Responsibilities
Responsibilities for Senior Claim Adjudicator:
- Utilize claims processing experience and working knowledge of Medicare and Medicaid to effectively and efficiently process claims for payment while adhering to internal deadlines.
- Demonstrate ability to handle daily workload with speed and accuracy.
- Demonstrate a high comfort level in working with large volumes of data.
- Demonstrate the ability to act as a mentor for others within team.
- Demonstrate a strong attention to detail and a commitment to customer service throughout the claims process.
- Additional duties and specific projects as assigned.
Qualifications
Qualifications for Senior Claim Adjudicator:
- Associate Degree or higher or equivalent work experience.
- Minimum five years of recent adjudication experience required.
- An ability to define and calculate Medicare and Medicaid is critical.
- Working knowledge of medical terminology, billing standards, and Medicare and Medicaid methodologies.
- Proficiency in Microsoft Office Suite and strong written and verbal communication skills are also required.
- CPC, COC, CIC, or Specialty Medical Coding Certification preferred.
If you would like to speak with our Talent Acquisition team to learn more about this position and NaphCare, please first apply directly to this position to initiate the application process, and then please send your resume to jerry.hughes@NaphCare.com where we will be in touch.
Equal Opportunity Employer: disability/veteran
#NCE
Company
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