Accounts Payable Assistant / Claims Adjustment Specialist I

Job Title: Accounts Payable Assistant / Claims Adjustment Specialist I
Location: New York, NY 10004
Duration: 04/27/2026 – 06/20/2026
Shift: 9:00 AM – 5:00 PM
Schedule: 5 days/week, 7 hrs/day, 35 hrs/week, No on-call
Schedule Notes: Monday–Friday; Hybrid work setting; Minimum 3 years of healthcare claims operations experience required; Experience with claims adjudication systems and CRM (Salesforce preferred); Strong knowledge of CPT, ICD-10, and Revenue Codes required; Experience with HCFA and UB04 forms required
Work Setting: Managed Care / Health Plan (Non-Patient Facing)
Pay Range: $25-$28/hr.

Requirements
Required Skills & Experience:

• Minimum 3 years of claims operations experience in a healthcare setting
• Experience with claims adjudication and adjustment processes
• Strong analytical and problem-solving skills
• Experience working with claims processing systems and CRM tools (Salesforce preferred)
• Proficiency in Excel and Word
• Knowledge of medical terminology, CPT, ICD-10, and Revenue Codes
• Experience processing medical claim forms (HCFA, UB04)
• Experience handling provider claim inquiries
• Knowledge of HIPAA guidelines and data privacy compliance

Education

• High School Diploma or GED required
• Associate Degree preferred

Certifications & Licensure

• Not specified

Job Summary
Responsible for reviewing, analyzing, and adjusting post-paid medical claims to ensure accuracy and resolve overpayments or underpayments while maintaining compliance with healthcare regulations and internal policies.

Job Responsibilities

• Research and analyze medical claims and supporting documentation
• Adjust claims based on coding, reimbursement rates, and authorization findings
• Apply payment guidelines, CMS/Medicare/Medicaid rules, and benefit plans
• Communicate with providers regarding claim discrepancies and required information
• Maintain accurate records and documentation of claim adjustments
• Generate reports and respond to claim audits
• Collaborate with internal teams to resolve claim issues
• Stay updated on changes in claims processing and coding systems