Click here to load

About Imagenet

Imagenet is a premier healthcare technology company that has taken medical claims processing and document management to new levels of service, security and efficiency. Our core business is helping our clients reduce costs and increase productivity by providing efficient document imaging, data validation, adjudication and on demand retrieval of documents and data.

Job Description

·         Analyze and process a variety health claim forms; UB-04, CMS-1500 or ADA

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

·         Review Medicare, Medicaid and Commercial services for appropriateness of charges

·         Authorize claim payments within established limits; otherwise forward to Claims Manager

·         Process refunds and letters of dual coverage (when applicable);

·         Identify process improvement opportunities within the claim department and recommend system enhancements

·         Handles any additional responsibility which may be assigned

Requirements

Education:

·         High School Diploma or equivalent required

Experience:

·         Minimum of one-year experience working closely with health claims or in a claims processing environment; required

Technical Skills / Knowledge:

·         Understanding of health claims processing

·         Ability to perform basic to intermediate mathematical computation routines

·         Medical terminology strongly preferred

·         Understanding of ICD-9 & ICD-10

·         Basic MS office computer skills

Other Skills Required

Ability to work independently or within a team

Time management skills

Written and verbal communication skills

Attention to detail

Must be able to demonstrate sound decision making skills