Claims Examiner III

 

Claims Examiner III

 

Medica HealthCare Plans, a rapidly growing Managed Healthcare Company located in Coral Gables is seeking a Claims Examiner III.

 

ESSENTIAL SKILLS: Good data entry skills in processing professional and institutional claims (pay, deny, suspend).Strong knowledge of claims processing guidelines for Medicare and/or Medicaid.Knowledge of medical terminology in relation to claims adjudicationGenerate letters as required by the product line.Knowledge of claims coding utilizing CPT’s, HCPCS, and ICD9.

 

QUALIFICATIONS

 

High School Diploma, 3 years of college or equivalent in work experience. Five (5) years minimum experience adjudicating claims in a managed care / indemnity setting.  Knowledge of medical terminology. Good computer skills and data entry accuracy in a windows environment. 

 

Medica offers a generous compensation package including: Vacation, Medical, Dental, Vision, and 401-K.

 E-mail resumes to: HR@medicaplans.com   We are a Drug Free Workplace / EOE