Claims Examiner at Correctional Health Partners

CLAIMS EXAMINER:Correctional Health Partners (CHP) specializes in customized third-party administrative (TPA) services. We develop strong working relationships with hospitals and providers with a focus on trust compassion and integrity. Our teamwork-driven services ensure that CHP serves the needs of each unique partnership while prioritizing best healthcare practices.We are looking for aClaims Examinerto process provider and facility claims according to the fee schedule/rates specified within the providers contracts while applying the restrictions contained in the benefit plan and coding guidelines. Verifies eligibility and authorization prior to adjudication. Manages workflow to maintain turnaround time requirements. Adjudicates claims within Quality Assurance standards.Thepositionrequires a strong understanding of healthcare terminology claims systems and payer guidelinesincluding Medicare Medicaid and commercial insurance. Collaborates with other departments in refining/improving processes. Provides feedback to the supervisor on trends and issues observed as opportunities for process improvement. Provides customer service for incoming and outgoing inquiries.Applicants must live in Colorado.Qualifications (Education/Experience/Knowledge/Skills/Abilities):High School Diploma/GEDThree to five years experience working in a managed healthcare environment.Minimum of two years of combined experience processing healthcare claims/appeals or adjudication.Knowledge of medical terminology CPT/ICD-10/HCPC coding and EOB/EOP interpretation.Proficiency in claims processing systemsAttention to detail and accuracyTime management and prioritizationCritical thinking and decision-makingWritten and verbal communicationTeam collaboration and adaptabilityUnderstanding of HIPAA and confidentiality protocolsMust adhere to CHPs five core values:Integrity:To do the right thing even when nobody is watching.Teamwork:To collaborate and to support each other in achieving a common goal.Accountability:To take responsibility for our successes and failures and to hold ourselves and others to high-standards.Patient-centered:To identify patient needs and provide optimal patient care.Compassion:To be empathetic toward the needs of our clients patients and coworkers.Correctional Health Partners offers a professional atmosphere competitive salaries and a full range of benefits. Benefits we provide include:401(k) plan.Medical dental and vision benefits.Flex spending medical and dependent care plans are available.Paid time off up to 28 days per year based on tenure and position.Paid holidays: We recognize 11 holidays.Education tuition reimbursement.Exercise incentive program.Compensation Range: $23.00 - $27.00 hourlyCorrectional Health Partners is an Equal Opportunity Employer.All qualified applicants will receive consideration for employment without regard to race color religion sex age national origin protected veteran status disability status sexual orientation gender identity or expression marital status genetic information or any other characteristic protected by law. Key Skills Auditing,GAAP,Military Experience,Phlebotomy,Conflict Management,Vital Signs Experience,Computer Forensics,Research Experience,Securities Law,Operating Systems,PTSD Care,RMF Employment Type : Full Time Experience: years Vacancy: 1 Hourly Salary Salary: 23 - 27