Claims Coordinator
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Job Description
Claims Coordinator processing healthcare claims for Machinify’s AI-powered health plan platform. Reviewing documents, entering claim data, routing files, and ensuring HIPAA-compliant processing.
Responsibilities:
- Monitor incoming claim notifications and ensure all required documents are complete and legible
- Verify required submission documents are present and legible
- Perform initial claim setup, accurately enter data, and assign correct claim statuses
- Perform initial analysis of client-submitted claims, EOBs, bills, policies, correspondence, and other documents
- Combine and extract claim documents when needed
- Copy combined files and rename them according to policy and procedures
- Enter UB04 data information for analysts
- Transfer claim documents to Document Management and IBR departments
- Create appeal letters and return them to clients
- Analyze client-provided coversheets for correct reimbursement
- Adjust the system to reflect correct reimbursement and savings
- Escalate problematic claims to the Lead of Claim Processing
- Notify the Lead of Claim Coordinator when documents are missing or illegible
- Maintain compliance with HIPAA and other security requirements
- Perform other duties as assigned
Requirements:
- Minimum typing speed of 40 WPM
- Strong data entry skills with a high degree of accuracy
- Intermediate to advanced computer proficiency, including Microsoft Office Suite and Adobe Acrobat
- Ability to work across multiple monitors
- Ability to quickly learn company-specific software
- Exceptional attention to detail
- Strong organizational, analytical, and critical thinking skills
- Strong interpersonal and team-building skills
- Ability to collaborate across a diverse team and drive change across functional and business boundaries
Benefits:
- PTO, Paid Holidays, and Volunteer Days
- Eligibility for health, vision and dental coverage
- 401(k) plan participation with company match
- Flexible spending accounts
- Tuition Reimbursement
- Company-paid life insurance
- Company-paid short-term disability
- Company-paid parental leave
- Remote and hybrid work options
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