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Healthcare Claims Specialist

EvryhealthHealth Insurance company
RemoteMid
Operations & Strategy

About the role

Manage end-to-end claims adjudication process for Evry Health.

  • Evry Health is seeking a Claims Specialist to manage the end-to-end claims adjudication process.
  • Key Responsibilities Review and process claims according to plan benefits and contractual reimbursement terms.
  • Follow established policies and procedures to pay, pend, or deny claims.
  • Process claims subject to Coordination of Benefits (COB) according to plan benefits, COB rules and contractual reimbursement terms.
  • Requirements Minimum of 3 years' medical claim adjudication/examination experience.
  • Knowledge of medical and insurance industry terminology including CPT/ICD-10, HCPCS and Revenue Codes.
  • Strong attention to detail and problem-solving skills with a high level of accuracy.
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Level:Mid

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