Jobs in Salem, United States
Examiner, Claims (Remote, Must Reside in Florida)
Molina Healthcare
Discover more opportunities than anywhere else. Find more jobs now
Connect with headhunters to apply for similar jobsManager, Healthcare Analytics - SQL/Power BI/Databricks - Remote - 2033281
Molina Healthcare
Examiner, Claims (Remote, Must Reside in Florida)
Job summary
A leading healthcare company in Tampa is looking for a Claims Administrator to manage claims payments and maintain records. The ideal candidate will have 1-3 years of experience and an HS Diploma. Responsibilities include evaluating claims for errors and ensuring timely processing. This role offers a competitive hourly pay range of $13.55 - $26.42.
Benefits
Qualifications
- 1-3 years of experience in claims management required.
- 3-5 years of experience preferred.
Responsibilities
- Administer claims payments and maintain claim records.
- Monitor workflow of claims and ensure timely settlements.
- Evaluate claims for incorrect coding and potential fraud.
Skills
Education
Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards.
Evaluates the adjudication of claims using standard principles and state specific policies and regulations in order to identify incorrect coding, abuse and fraudulent billing practices, waste, overpayments, and processing errors of claims.
Manages a caseload of claims. Procures all medical records and statements that support the claim.
Makes recommendations for further investigation or resolution.
Reduces defects via pro-active identification of error issues as it relates to pre-payment of claims through adjudication and trends and recommending solutions to resolve these issues.
Supports all department initiatives in improving overall efficiency.
Meets department quality and production standards.
Other duties as assigned.
Required Education
HS Diploma or GED
Required Experience
1-3 years
Preferred Education
Associate degree or equivalent combination of education and experience
Preferred Experience
3-5 years
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $13.55 - $26.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
* The salary benchmark is based on the target salaries of market leaders in their relevant sectors. It is intended to serve as a guide to help Premium Members assess open positions and to help in salary negotiations. The salary benchmark is not provided directly by the company, which could be significantly higher or lower.