Bilingual Claims Review Representative
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Job Description
Claims Review Representative in a remote role processing medical claims and collaborating with staff. Evaluating information and interpreting administrative procedures with discretion.
Responsibilities:
- Partners with professional staff on pre-screening review by applying guidance, and making appropriate decisions
- Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures
- Works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes
Requirements:
- Fully Bilingual in Spanish/English
- Minimum of 1 year of strong and proven experience with processing and adjudicating medical claims
- Knowledge with CPT, ICD9, and ICD10 terminology/codes
- Proficiency in Microsoft Office applications including Word, Excel and Outlook
Benefits:
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance
- many other opportunities
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