- Review and adjudicate all types of claims designated as “production claims”, meeting production and quality goals.
- Apply benefit plan rules and processing guidelines to pay, pend, or deny claims.
- Manage and follow up timely on all pending claims and correspondence, including review of patient claim history.
- Review and determine eligibility and coverage for specific group/plan.
- Research claim problems and take necessary actions to resolve.
- Utilize training and on-line documentation to keep up to date on processing guidelines, insurance principles, DOL rules and regulations, and benefit plan rules.
- Update claims system with applicable claim/and patient notes.
- Contact employers, providers, participants, as necessary.
- Utilize Claim Workflow system for work assignments, routing, and follow up.
- Handle other claim-related duties, projects, and assignments as assigned, including the handling of claim exceptions and provider not found claims.
Qualifications:
- One to two years of college or equivalent experience.
- Medical billing and/or AMA coding experience preferred.
- Data Entry experience or equivalent type work using keyboard/PC.
This is a Union position.
Benefits from Amalgamated:
- Hybrid work environment. 4 days in White Plains, NY with 1 scheduled work from home day.
- Commuter benefits including free onsite parking and shuttle service from White Plains Train Station.
- Training, growth and development opportunities.
- Generous vacation, paid time off and holidays.
- Subsidized company-sponsored Medical, Dental, and Vision insurance.
- Employer sponsored life insurance and long-term disability.
- Employee Assistance Program.
- 401K plan with employer contribution.
- Defined benefit pension.
- A team working environment with an established culture of inclusion and belonging which supports a healthy work/life balance.
- Employee recognition events.
About Amalgamated Life Insurance Company
Amalgamated Life is a leading provider of life and health insurance serving working men and women since 1943. Amalgamated Life has consistently earned the “A” (Excellent) rating from A.M. Best Company since 1975, attesting to our proven policies and procedures, adherence to the industry’s highest standards, strong fiscal conditions and excellent claims-paying ability.
Job Type: Full-time
Pay: $46,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Tuition reimbursement
- Vision insurance
Work Location: Hybrid remote in West Harrison, NY 10604
