Remote Medical Claims Adjudicator Job at Randstad USA, Westminster, CO

a2tMcis3bFhuUys0RnNxUmswK1dlbFc4aHc9PQ==
  • Randstad USA
  • Westminster, CO

Job Description

Are you a meticulous and experienced professional with a keen eye for detail? We are seeking a Medical Claims Processor to join our team. In this remote position, you will play a key role in the payment and denial of medical claims, ensuring accuracy and compliance with established guidelines.

Position Overview

This is a 5-month contract with the possibility of an extension and the opportunity to apply for permanent positions. You will be responsible for the adjudication of medical claims and bills, which involves analyzing data, applying benefit criteria, and ensuring all documentation meets contractual and governmental requirements.

Top Daily Responsibilities

  • Adjudicate medical claims/bills for payment or denial based on contractual agreements and medical regulations.
  • Verify claims/bills meet eligibility, benefit, and Medicare requirements.
  • Research and respond to questions and complaints from vendors and members.

Required Skills & Experience

  • A minimum of 3 years of claims processing adjudication experience REQUIRED! Specifically, experience with payment determination, not just billing.
  • Knowledge of medical terminology and coding systems, including ICD-10 and CPT .
  • The ability to analyze and interpret procedures and practices related to claims adjudication with minimal supervision.
  • Basic PC skills and a working knowledge of Microsoft Word .

Job Details

  • Schedule: Monday - Friday, 8:00 AM to 4:30 PM.
  • Location: 100% remote. You may be required to go to the office at 2500 S. Havana St., Aurora, CO 80014 , to pick up equipment.

Job Tags

Permanent employment, Contract work, Work at office, Monday to Friday,

Similar Jobs

Insight Global

Regulatory Affairs Associate Job at Insight Global

Regulatory Site Quality Specialist Location: hybrid (Florham Park, NJ Type: Contract | Full-Time Industry: Large Consumer Packaged Goods (CPG) Company Job Overview We are seeking a Regulatory Site Quality Specialist to support a leading CPG company...

Guthrie

Patient Care Partner - Float Pool - Part Time Job at Guthrie

 ...Education, License, & Cert: High School Grad or Equivalent Experience: No experience required Essential Functions:...  ...and department. Receives and sends messages in an accurate and timely fashion. - Communicates with the patients, family, and members... 

Guthrie

Phlebotomist I - Laboratory Collection - Per Diem Job at Guthrie

 ...4. Answering the phone and interacting with patients, nurses, providers, and other health care professionals to ensure high customer satisfaction. 5...  ...specimen collection. 2. Phlebotomists may be required to travel to perform specimen collections. 3. Other duties as... 

Starwood Custom Homes

Social Media / Digital Marketing Coordinator Job at Starwood Custom Homes

 ...including Top Companies to Work For), and were committed to continuously raising the bar. What You'll Do As Social Media / Digital Marketing Coordinator, youll lead the strategy, execution, and optimization of our marketing initiatives both internal and external... 

NextGen | GTA: A Kelly Telecom Company

Technical Writer Job at NextGen | GTA: A Kelly Telecom Company

 ...government-issued RFPs and extract technical & administrative requirements Develop point-by-point proposal responses aligned to evaluation criteria Act as primary liaison with Contracting Officers , including clarifications and post-submission questions...