Claims Processor II

Brooklyn NY 11201

Job Description

Responsible and accountable for the accurate and timely claims processing of all claim types. Claims must be processed with a high level of detailed quality and in accordance with claims payment policy and by the terms of our customer/provider contractual agreements.
  • Adjudicates claims and adjustments as required.
  • Resolves claims edits and suspended claims.
  • Maintains and updates required reference materials to adjudicate claims.
  • Provides backup support to other team/group members in the performance of job duties as assigned.

General Job Information

Title

Claims Processor II

Grade

17

Job Family

Operations Group

Country

United States of America

FLSA Status

United States of America (Non-Exempt)

Recruiting Start Date

4/1/2019

Date Requisition Created

4/1/2019

Minimum Qualifications

Education

GED (Required), High School (Required)

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

- Ability to quickly use a 10-key machine- Experience with list of ICD-9 codes and Current Procedural Terminology (CPT)

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.