Accounts Payable Claims Adjudicator

Analyze Claims

Analyze and adjudicate a variety of claim types to include facility, professional, inpatient and outpatient services.

Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations.

Interpret Contract Benefits

Interpret contract benefits in accordance with specific claims processing guidelines.

Workflow Coordination

• Receive, organize, and make daily use of information.
• Cookinate daily workflow to coincide with payment cycle.

Accounts Payable Management

• Responsible for participating in management in the overall accounts payable functions in the organization.

Education and Qualifications

• High School diploma or GED equivalent.
• Associate’s degree in related field is preferred.
• Minimum of one (1) year related experience required.
• Experience in medical/insurance preferred.

Essential Job Responsibilities

• Team-centered with excellent work ethic and reliability.
• Experience with UB/institutional (CMS-UB04) and HCFA/professional (CMS-1500) claims.
• Familiarity with medical terminology, procedure and diagnosis codes preferred.
• Ability to calculate figures and co-insurance amounts.

EEO Statement

Gulfside Healthcare Services, Inc. is committed to Equal Employment Opportunity (“EEO”) and complies with all federal, state, and local laws that prohibit workplace discrimination and unlawful retaliation.

Background Screening Requirement

Note: All Gulfside Healthcare Services positions (except some Thrift Shoppe Positions) require an AHCA Level 2 Fingerprint screening for eligibility through the AHCA Florida Care Provider Background Screening Clearinghouse. Please refer to this link for more information on this: https://info.flclearinghouse.com.