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Medical Claim Appeals Adjudicator/ Arbitrator / Remote (NYS residency required)


Job title: Medical Claim Appeals Adjudicator/ Arbitrator / Remote (NYS residency required)

Company: Med-Scribe

Job description: Med-Scribe, Inc is a staffing agency that has been recruiting top talent within the healthcare industry for over 35 years! As a small, local agency deeply rooted in our community, we’re passionate about pairing exceptional candidates with the perfect opportunities.Are you detail-oriented, knowledgeable, and ready to make a significant impact in the healthcare industry? Med-Scribe is looking for skilled candidates to join a growing organization in processing appeals for medical claims. In this crucial role, your expertise will ensure fair and timely resolutions. This position spans across the insurance, legal, and medical arenas. It is a temp to hire opportunity, with the expectation you are hired on permanently after a 3-6 month time frame.Background/experience considered include: healthcare law, arbitration, mediation, dispute resolution, claims adjudication in health care, healthcare coding.Job Duties (Include but not limited to):

  • Rendering payment determinations on disputes between healthcare providers and health plans
  • Acting as a subject matter expert for the most complex appeals and hearings cases
  • Evaluating data associated with complex issues to determine compliance or to make exceptions to applicable regulations/policies.
  • Providing Complaint resolution to customers as needed
  • Attending hears and/or meetings to discuss cases
  • Any other related duties as assigned.

Hours: Mon-Fri: between 8 AM – 5 PMSalary: $25/hrMinimum Qualifications:

  • Bachelor’s degree required.
  • Law degree, paralegal certification, or registered nurse strongly preferred
  • Minimum 5 years of experience in payment determinations preferred. Certifications in lieu of experience will be considered.
  • Experience in healthcare law, arbitration, mediation, dispute resolution, or claims adjudication in healthcare required
  • Healthcare Coding experience preferred.
  • Strong analytical and critical thinking skills.
  • Persuasive Communication Skills (both written and verbal)
  • Ability to handle sensitive information with integrity and confidentiality.
  • Experience working with federal healthcare regulations.
  • Attention to detail.
  • Ability to work efficiently and independently.
  • Ability to follow processes and procedures.

Expected salary: $25 per hour

Location: Pittsford, NY

Job date: Wed, 24 Jul 2024 22:38:07 GMT

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