Part Time Medical Claims Examiner - Now Hiring
Integrity is one of the nation's leading independent distributors of life, health and wealth insurance products. With a strong insurtech focus, we embrace a broad and innovative approach to serving agents and clients alike. Integrity is driven by a singular purpose:
to help people protect their health and wealth so they can be ready for the good days ahead.
Headquartered in Dallas, Texas, Integrity is committed to meeting Americans wherever they are -- in person, over the phone or online. Integrity's employees support hundreds of thousands of independent agents who serve the needs of millions of clients nationwide. For more information, visit.
ABOUT INSURANCE ADMINISTRATIVE SOLUTIONS
Insurance Administrative Solutions (IAS) is a third-party provider of comprehensive administrative solutions for our clients in the insurance industry. We offer a business process outsourcing solution that helps insurers optimize administrative workload, bolster their industry expertise, leverage emerging technologies, and streamline operations. With strong industry knowledge, we deliver value to our customers by providing compassionate customer service, efficient processing, and quality results. Here at IAS, we embrace the fact that great things are only accomplished by working as a team. We believe that all of our employees have valuable input no matter the level. Our highly collaborative team environment offers each of our employees a place where they can excel.
Location:
Rome, GA
JOB
Summary:
This position is responsible for analyzing and researching medical claims by reviewing medical records and billing documentation. This position involves extensive research, written and telephonic correspondence and review of medical records and other documents for eligibility determination.
Candidate must be local. This is not a remote position, at this time.
ESSENTIAL DUTIES &a; RESPONSIBILITIES (other duties may be assigned as necessary):
- Conducting investigations into claimant health history through review of medical records and billing documentation
- Interpreting insurance contract benefits and definitions
- Making decisions about claim payments and claimant eligibility
EDUCATION and/or EXPERIENCE REQUIRED:
- 3-5 years RN hospital nursing experience or other equivalent hands-on medical industry experience
- Oncology, cardiology, or surgery preferred
- Previous experience with chart review
- Knowledge of medical terminology and conditions
- Knowledge of medical prognoses and treatment
- Excellent oral and written communication skills
- Intermediate experience with Microsoft Word and Excel
- Highest standards of accuracy and attention to detail
Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Medical terminology is needed. Previous Cancer, Health, Medicare, Rx claims adjudication preferred. Must have organizational and decision making skills. Ability to work independently and exhibit flexibility in performing multiple functions. Team centered with excellent work ethic and reliability. Good PC application skills a plus. Ability to read and interpret EOB&s;s. Clear understanding of the policy benefits and procedures within the Claims department. Honesty, as well as respect, for the company and its policies &a; procedures is crucial.
SCHEDULE:
- Monday to Friday
- 20 - 24 hour work week
Integrity offers you the opportunity to start a career in a family-like environment that is rewarding and cutting edge. Why? Because we put our people first! At Integrity, you can start a new career path at company you'll love, and we'll love you back. We're proud of the work we do and the culture we've built, where we celebrate your hard work and support you daily.
Joining us means being part of a hyper-growth company with tons of professional opportunities for you to accelerate your career. Integrity offers our people a competitive compensation package, including benefits that make work more fun and give you and your family peace of mind.
Integrity Marketing Group, LLC is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national origin, disability, veteran status, or any other characteristic protected by federal, state, or local law. In addition, Integrity Marketing Group, LLC will provide reasonable accommodations for qualified individuals with disabilities
PandoLogic. Keywords:
Insurance Examiner, Location:
Trion, GA - 30753Salary:
$38 per hourEstimated Salary: $20 to $28 per hour based on qualifications.
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