Medical Claim Representative

Resolve client health premiums and out of pocket medical expenses by reviewing medical documentation and looking at gaps in medical documentation or records that could help with payment guidelines. Ability to read and identify missing Clinical Documentation, Enrollment; Payment Terms, out of pocket expenses; Benefits Coordination with other insurance coverage.

Medical Claims Processor 
Located in Glastonbury, CT

J. Morrissey, in partnership with our Client, is seeking a Medical Claims Processor.  At this 3rd Party Administrator, you will be working with healthcare claims pertaining to benefits and payments.   

Monday through Friday: 11:30am - 8:00pm 

Pay Rate:  $24.00 Per Hour based on Experience 

Job Responsibilities:

Resolve client health premiums and out of pocket medical expenses by reviewing medical documentation and looking at gaps in medical documentation or records that could help with payment guidelines.

A representative list of duties: 

• Answer phones and respond to client inquiries related to payments made on their behalf. 
• Make outgoing calls to clients, medical providers, and insurance companies resolving any gaps 
• Identify, research and resolve client issues.
• Ensure payment processing timeliness and accuracy are met.
• Send follow up letters for approvals and / or denial letters.

Required Skills:

• Experience in the Revenue Cycle: Medical Billing, Medical Collections, Insurance Follow up etc. required. 
• Understanding of EOBs, Form 1500 and UB-04’s.
• Solid understanding of payor / insurance  methodologies  
• Ability to read and identify missing Clinical Documentation, Enrollment; Payment Terms, out of pocket expenses; Benefits Coordination with other insurance coverage.
• Bi - Lingual Spanish 

This role is in a very nice office building that is easy to access with Free onsite parking and a cafeteria.  

#INDH