Medical Claims Examiner
Pride Health, New York, NY, United States
Job Title: Medical Claims Examiner
Location: New York, NY 10004
Schedule: Monday – Friday | 9:00 AM – 5:00 PM
Contract Duration: 2 Months with a strong possibility of further extension
Pay Rate: $28 – $32/hr.
Key Responsibilities:
Process medical and surgical provider claims accurately and efficiently
Review claims for complete member and provider information
Apply claims processing guidelines and administrative policies
Evaluate claims discrepancies and resolve payment issues
Review service descriptions for billing accuracy and errors
Generate provider correspondence to obtain additional claim information
Maintain production and quality standards for claims processing
Update claims manuals and reference materials as needed
Required Qualifications:
Associate Degree or equivalent combination of education and experience
2+ years of healthcare insurance or claims processing experience
Knowledge of integrated claims processing systems
Proficient data entry skills
Knowledge of medical terminology, CPT, ICD, and revenue codes (required)
Preferred Skills:
Experience with provider claims adjudication
Strong auditing and claims review experience
Familiarity with healthcare billing regulations
Excellent attention to detail and accuracy
“Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors”.
Location: New York, NY 10004
Schedule: Monday – Friday | 9:00 AM – 5:00 PM
Contract Duration: 2 Months with a strong possibility of further extension
Pay Rate: $28 – $32/hr.
Key Responsibilities:
Process medical and surgical provider claims accurately and efficiently
Review claims for complete member and provider information
Apply claims processing guidelines and administrative policies
Evaluate claims discrepancies and resolve payment issues
Review service descriptions for billing accuracy and errors
Generate provider correspondence to obtain additional claim information
Maintain production and quality standards for claims processing
Update claims manuals and reference materials as needed
Required Qualifications:
Associate Degree or equivalent combination of education and experience
2+ years of healthcare insurance or claims processing experience
Knowledge of integrated claims processing systems
Proficient data entry skills
Knowledge of medical terminology, CPT, ICD, and revenue codes (required)
Preferred Skills:
Experience with provider claims adjudication
Strong auditing and claims review experience
Familiarity with healthcare billing regulations
Excellent attention to detail and accuracy
“Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors”.