Third Party Administrator (TPA) of self-funded health benefits is seeking Medical Claims Analyst responsible for accurate and timely adjudication of medical, dental, vision and pharmacy claims.
- Must demonstrate proficiency in the operation of claims processing software and hardware.
- Must have an excellent understanding of health benefits concepts and their application in the adjudication of claims.
- Must be able to accurately assess financial responsibility and liability for claims submitted by providers.
- Accurate input of data is required for claims adjudication.
- Examiners are expected to maintain 98 percent statistical/financial accuracy.
- Examiners must meet timeliness requirements for the product line(s) they are responsible for processing.
- Take calls from Providers regarding claim status and perform research as required..
- Ensure the privacy and security of PHI (Protected Health Information) as required under HIPAA.
One (1) to three (3) years processing of health claims.
Strong working knowledge of ICD.9.CM, CPT, HCPCS, Revenue and DRG coding schemes and medical terminology required.
Prodegi Corporate Benefit Services
Why Work Here?Prodegi is a Third Party Administrator (TPA) of self-funded employee health benefits with over 35 years of success in the Benefits Administration business. We have refined the administration of self-funded health benefits in a way that saves employers time and money while helping them improve employee satisfaction and retention. By building a team of bright, talented and passionate people that are working faster, smarter and more efficiently, we are ensuring a future of growth and customer satisfaction, as well as greater success and opportunity for our employees.
Prodegi is a dynamic, growing company with a team that's passionate, create and quality-driven.