Contractor Medical Claims Examiner

Responsibilities

Kforce has a client that is looking to hire Medical Claims Examiners. The role is fully remote, but candidates need to be located with 2 hours of the client's primary office site in Aurora, CO. Top Daily Responsibilities:

• Medical Claims Examiner coordinates claims operations and modifications with other areas of the organization
• Monitors workflow to achieve established goals and objectives
• Responsible for abiding by all guidelines, procedures, and policies
• Learning and applying knowledge of medical claim/bill payment processing and medical regulations
• As a Medical Claims Examiner, you will utilize knowledge of organizational policies and procedures to ensure adherence to contractual agreements and non-contracted pricing arrangements along with compliance with government regulations
• Researches claims/bills for appropriate support documents and documentation
• Responds to vendor and member problems, questions and complaints

Requirements

• High School diploma or General Education Development (GED) required
• Qualified candidates will have a minimum of 3 years of experience in claims processing, ideally in a medical claims processing environment

The pay range is the lowest to highest compensation we reasonably in good faith believe we would pay at posting for this role. We may ultimately pay more or less than this range. Employee pay is based on factors like relevant education, qualifications, certifications, experience, skills, seniority, location, performance, union contract and business needs. This range may be modified in the future.

We offer comprehensive benefits including medical/dental/vision insurance, HSA, FSA, 401(k), and life, disability & ADD insurance to eligible employees. Salaried personnel receive paid time off. Hourly employees are not eligible for paid time off unless required by law. Hourly employees on a Service Contract Act project are eligible for paid sick leave.

Note: Pay is not considered compensation until it is earned, vested and determinable. The amount and availability of any compensation remains in Kforce's sole discretion unless and until paid and may be modified in its discretion consistent with the law.

This job is not eligible for bonuses, incentives or commissions.

Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.