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Claims Examiner Insurance Company HMO Experience

Operations | Miami, FL | Full Time

Job Description

About Us:

We are a service-based company and as a licensed third party administrator, we are seeking only top talent and experienced personnel in order to meet and exceed our client's expectations. We’re an innovative company creating a unique experience for healthcare professionals. While many industry-wide solutions exist, nothing comes close to our ground-breaking approach.

The ideal Claims Examiner- Claims Processor must have the ability to understand health benefits, read policy terms and conditions and have a clear understanding of deductibles, co-payments, coinsurance, policy terms and conditions limits and exclusions. Prior work experience working in an insurance company, advantage health plan, administering self-funded health plans or an HMO.

Knowledge of medical claims coding, different medical specialties and medical services billed for payment by providers to insurance companies is a must.

The candidate (s) must have the ability to communicate with customers in proficient English, write emails and handle phone calls from customers in a professional and efficient manner.

Bonus Points:

  • PayerFusion provides competitive compensation. Base compensation commences with experience, and knowledge of the claims administration industry.
  • PayerFusion provides competitive benefits that include vacation, holiday, sick-time as well as health insurance and other corporate benefits.