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Job Requirements of Admin Service:
-
Employment Type:
Contractor
-
Location:
New York, NY (Onsite)
Do you meet the requirements for this job?
Admin Service
Careers Integrated Resources Inc
New York, NY (Onsite)
Contractor
Job Title: Admin Service
Job Duration: 6 months (Possible Extension)
Job Location: REMOTE EST
Shift hours: First shift.
Pay Rate: $17.00/hr on w2
HS Diploma and/or GED and one plus year of experience.
Responsibilities:
Requirements:
Job Duration: 6 months (Possible Extension)
Job Location: REMOTE EST
Shift hours: First shift.
Pay Rate: $17.00/hr on w2
HS Diploma and/or GED and one plus year of experience.
Responsibilities:
- Adjudicate reconsideration determinations for disputes between enrollees, providers, and Medicare Plans by using federal law, federal regulations, relevant contract law and other sources as defined by the client contract.
- Reviews of appellant dismissals and technical issues such as cost-sharing and lock-in.
- Write clear and accurate decision letters.
- Requests additional information from Medicare Health Plans as appropriate.
- Accurately updates the various systems and reviews data from other databases.
- Escalates potential Privacy issues to the appropriate department.
- Follows policies and procedures without deviation.
- Assists supervisor with special projects and tasks on an as needed basis.
Requirements:
- 2 years’ experience in healthcare, claims and/claims or account processing required
- Knowledge of Medical and Insurance Terminology
- Strong analytical and critical thinking skills.
- Proficiency in Microsoft Office Suite and experience with database management
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