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Claims Representative II

The Judge Group Troy Full-Time
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Judge Healthcare is currently seeking a Claims Representative for one of our best healthcare clients in the Troy, MI area. Please send updated resumes to Emily at Email blocked - click to apply.

This job will have the following responsibilities:
  • Handles written response to incoming reconsideration requests from providers and outside agencies.
  • Enters provider demographic and contract affiliation information into the health plan system.
  • Researches and documents inquiries and proactive research in a thorough, professional and expedient manner.
  • Completes appropriate documentation for tracking/trending data.
  • Composes correspondence to reflect accurate resolution information in a clear, concise, grammatically correct format.
  • Maintains tracking system of correspondence and outcomes of request; maintain organized and accurate files.
  • Monitors each request to ensure all internal and regulatory timelines are met.
  • Communicates with Provider Service Representatives regarding relevant provider issues.

Qualifications & Requirements:
  • High School Diploma or equivalent GED Required Experience: 2-4 years experience in a managed care setting. 
  • CPT and ICD-9 coding, data entry, and 10-Key experience.

Skills required

Accounts Receivable
Casualty Insurance
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Job ID: 584576


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The Judge Group is a privately owned, leading professional services firm with nearly 50 years of experience in providing technology, talent, and learning solutions. Our services are successfully delivered through a network of more than 35 offices in the United States, Canada, and India. The Judge Group serves more than 47 Fortune 100 companies and is responsible for 7,000 professionals on assignment annually across a wide range of industries.

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