Senior Claims Examiner (26-96)

About the role

The Senior Claims Examiner position is responsible for the accurate processing, adjustment, and payment of claims submitted by Network180's provider network. This role is 40 hours per week, Monday through Friday, from 8:00 AM to 5:00 PM. The position is remote but requires some in-person meetings within Kent County, Michigan.

Responsibilities

• Accurate processing, adjustment, and payment of claims submitted by Network180’s provider network.
• Knowledge of Medicaid, Medicare, and third-party insurances.
• Analysis of information and preparation of spreadsheets and reports.
• Prioritization of tasks and effective time management.
• Excellent communication and problem-solving skills.
• Excellent customer service skills.
• Lived experiences with mental illness, developmental disabilities, or substance use disorders are valued.

Requirements

• Bachelor’s degree in Business Management, Health Care Administration, Public Administration, or related field.
• At least two years of experience in a related field, such as billing, coding, and/or claims processing.
• Advanced computer skills including word processing, spreadsheets, database management, and email.
• Knowledge of Medicaid, Medicare, and third-party insurances.
• Skills and experience in analyzing information and preparing spreadsheets and reports.
• Ability to prioritize tasks and manage time effectively.
• Excellent communication skills, both verbally and written.
• Excellent problem-solving techniques.
• Excellent customer service skills.
• Lived experiences with mental illness, developmental disabilities, or substance use disorders valued.

Qualifications

Any combination of education, training, and experience providing the required knowledge, skills, and abilities to perform the essential functions of the job. Lived experiences with mental illness, developmental disabilities, or substance use disorders are valued.

Skills

Advanced computer skills including word processing, spreadsheets, database management, and email. Knowledge of Medicaid, Medicare, and third-party insurances. Skills and experience in analyzing information and preparing spreadsheets and reports. Ability to prioritize tasks and manage time in an effective and efficient manner. Excellent communication skills, both verbally and written. Excellent problem-solving techniques. Excellent customer service skills.

Benefits

• Four health insurance plans
• 100% employer-paid dental and vision insurance plans
• 13 paid holidays
• Generous PTO
• Professional development
• Tuition reimbursement
• Professional License reimbursement
• Defined contribution retirement plan
• Employee Assistance program
• Life and voluntary life insurance options
• Short and long-term disability
• Approved site for loan forgiveness (based on position and department): NHSC, STAR Loan Repayment, Behavioral Health Loan Repayment, MI Kids Now Loan Repayment and much more!

Pay

$26.04 - $34.52. The final job offer is based on several factors (internal equity, skills, education, experience, and credentials).

Schedule

This assignment is remote with some in-person meeting requirements within Kent County, Michigan.