Medical Claim Representative

Medical Claims Processor Located in Glastonbury, CT J. Morrissey, in partnership with our Client, is seeking a Medical Claims Processor. At this 3rd Party Administrator, you will be working with healthcare claims pertaining to benefits and payments. Monday through Friday: 11:30am - 8:00pm Pay Rate: $24.00 Per Hour based on Experience

• Resolve client health premiums and out of pocket medical expenses by reviewing medical documentation and looking at gaps in medical documentation or records that could help with payment guidelines.

A representative list of duties:

• Answer phones and respond to client inquiries related to payments made on their behalf.
• Make outgoing calls to clients, medical providers, and insurance companies resolving any gaps Identify, research and resolve client issues.
• Ensure payment processing timeliness and accuracy are met.
• Send follow up letters for approvals and / or denial letters.

• Experience in the Revenue Cycle:
  Medical Billing, Medical Collections, Insurance Follow up etc. required.
• Understanding of EOBs, Form 1500 and UB-04’s.
• Solid understanding of payor / insurance methodologies Ability to read and identify missing Clinical Documentation, Enrollment;
  Payment Terms, out of pocket expenses;
  Benefits Coordination with other insurance coverage.
• Bi - Lingual Spanish

This role is in a very nice office building that is easy to access with Free onsite parking and a cafeteria.