Claims Processor II

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $37.7k - $56.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

👻 Ghost score 0%

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Magellan Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

💰 $101M Private Equity Round - Magellan Health Services on 2004-01

Healthcare • Healthcare Insurance

Magellan Health is a healthcare organization focused on behavioral health and care-management services. The company provides clinical care managers, military and family life counselors, and behavioral health services across regional programs (e. g. , Magellan Hawai‘i, Magellan of New Mexico), and supports treatment coordination for mental health and substance abuse conditions. It also offers programs that support military families and other institutional clients, indicating work in managed behavioral health and care coordination.

📋 Description

• Process all claims accurately and timely • Adjudicate claims and adjustments as required • Resolve claims edits and suspended claims • Maintain and update reference materials for claims adjudication • Provide backup support to team/group members • Manually price claims using various tools and processes • Review daily material updates and provide feedback or suggestions • Partner with the Quality team on procedures and complex claims • Receive coaching from leadership

🎯 Requirements

• Demonstrated ability to navigate computer applications • Experience with ICD-9/10 codes and Current Procedural Terminology (CPT) • Demonstrated basic analytical skills • Basic written/oral communication skills • Demonstrated reading comprehension and ability to follow provided directions • Required work experience in Claims • Required education: GED or High School

🏖️ Benefits

• Short-term incentives may be available • Comprehensive benefits package • Health, life, voluntary, and other benefits • Physical, mental, emotional, and financial wellbeing perks • Tobacco-free workplace