Bilingual Claims Examiner

Job Description:

Are you an experienced Claims Representative looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!

Daily Responsibilities:

• Resolves Provider Reconsideration Requests (PRR) from providers relating to claims payment and requests for claim adjustments

• Researches claims processing guidelines, provider contracts, fee schedules and system configurations to determine root cause of payment error

• Identifies potential Provider problems through a proactive approach in which data is mined and trended to identify and prevent provider problem areas

Hours for this Position:

• Mon-Fri 8am-4:30pm

Advantages of this Opportunity:

• Competitive salary, negotiable based on relevant experience

• Acquire new skills and learn new knowledge

• Fun and positive work environment

Qualifications/ Requirements:

• Must be bilingual in Spanish

• Claims, Appeals, Denials experience for an insurance company or hospital or medical office or financial company

• HS Diploma/GED