LHH Recruitment Solutions
Medical Claims Examiner
LHH Recruitment Solutions, Chicago, Illinois, United States, 60290
LHH Recruitment Solutions
is seeking a Claims Examiner for our Client in Chicago. This position is offered on a hybrid schedule near the Pilsen area, and will be focused on analyzing and processing PPO, HMO, and other medical claims.
Position details: 100% onsite in Chicago - near Pilsen
Monday - Friday, 8AM-4PM (37.5 hours paid per week)
Contract to Hire
Position duties include:
Accurately and promptly handle medical and facility claims, ensuring all required details are included such as accident information, subrogation forms, other insurance details, referrals, pre-certifications, repricing, auditing, and any other relevant data necessary for proper claim processing.
Evaluate provider reconsideration requests and either reprocess the claim or issue letters as needed in response.
Address inquiries from colleagues or other departments via email or a ticketing system within three business days.
Manage check-run cycles and perform audits of these runs when assigned.
Conduct audits on auto-adjudicated claims as required.
Participate in meetings with vendors, providers, partnering organizations, or any other assigned meetings.
Identify and report system issues, test and troubleshoot system configurations, complete reports, and perform other system-related tasks as assigned.
Oversee pending claims to prevent unnecessary delays.
Track claims inventory to ensure timely processing across various plans.
Communicate with providers, members, and external vendors via mail, email, or phone.
Qualifications include:
5 or more years of experience as a Claims Examiner or Auditor
Must posses strong knowledge in medical claim processing and basic knowledge of ICD-10, CPT and HCPC codes
Strong understanding of UB 02 and HCFA 1500 claim forms, and plan documents and insurance policies
Pay Details:
$23.00 to $25.00 per hour
Search managed by:
Marissa Osorio
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
The California Fair Chance Act Los Angeles City Fair Chance Ordinance Los Angeles County Fair Chance Ordinance for Employers San Francisco Fair Chance Ordinance
is seeking a Claims Examiner for our Client in Chicago. This position is offered on a hybrid schedule near the Pilsen area, and will be focused on analyzing and processing PPO, HMO, and other medical claims.
Position details: 100% onsite in Chicago - near Pilsen
Monday - Friday, 8AM-4PM (37.5 hours paid per week)
Contract to Hire
Position duties include:
Accurately and promptly handle medical and facility claims, ensuring all required details are included such as accident information, subrogation forms, other insurance details, referrals, pre-certifications, repricing, auditing, and any other relevant data necessary for proper claim processing.
Evaluate provider reconsideration requests and either reprocess the claim or issue letters as needed in response.
Address inquiries from colleagues or other departments via email or a ticketing system within three business days.
Manage check-run cycles and perform audits of these runs when assigned.
Conduct audits on auto-adjudicated claims as required.
Participate in meetings with vendors, providers, partnering organizations, or any other assigned meetings.
Identify and report system issues, test and troubleshoot system configurations, complete reports, and perform other system-related tasks as assigned.
Oversee pending claims to prevent unnecessary delays.
Track claims inventory to ensure timely processing across various plans.
Communicate with providers, members, and external vendors via mail, email, or phone.
Qualifications include:
5 or more years of experience as a Claims Examiner or Auditor
Must posses strong knowledge in medical claim processing and basic knowledge of ICD-10, CPT and HCPC codes
Strong understanding of UB 02 and HCFA 1500 claim forms, and plan documents and insurance policies
Pay Details:
$23.00 to $25.00 per hour
Search managed by:
Marissa Osorio
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
The California Fair Chance Act Los Angeles City Fair Chance Ordinance Los Angeles County Fair Chance Ordinance for Employers San Francisco Fair Chance Ordinance