healthcare
Ideal Position For Math or Actuarial Science Major with B.S. or B.A.
Must possess the following traits:
- Tenacity
- Analytical Skills
- Drive / Ambition
- Independent Problem Solving
At Patriot RN, our Claims Examiners are ROCK STARS, who represent the top 10% of available talent in the market for the role.
VISIT www.PatriotRN.com to get more details about "A Day in the Life of a Claims Examiner," as well as review employee / alumni testimonials
Over the last 12 years, individuals starting in this role have ascended to supervisor, trainer, specialist, and other management roles by demonstrating their aptitude as a strong claims examiner over a period of 12 - 18 months of initial employment with Patriot RN.
START DATE: Monday, August 12, 2024
CLAIMS EXAMINER GENERAL JOB DUTIES:
- Adjudicate routine home health and facility-based claims for long-term care (LTC) products
- Review and pay claims according to the claimant's policy and prescribed plan of care. Verify the provider of care is appropriate and in accordance with contract language and government regulations regarding healthcare providers and matches the plan of care for the associated dates of service
- Determine benefit eligibility and payable amounts based on policy language and the client's required procedures
- Apply knowledge concerning state and federal regulations of the healthcare industry, government-funded programs, and private insurance, including HIPAA
- Detail-oriented, solid organizational skills, and independent problem-solver
- Strong math apptitude to perform benefit calculations
- Limber with the ability to work on multiple tasks
OTHER JOB REQUIREMENTS:
- Meet individual quality and performance metrics:
* 98% Financial Accuracy
* 98% Procedural Accuracy
* Average 42 Claims per Day
- Responsible for day-to-day decisions and updating management on department activity status
EDUCATION/EXPERIENCE:
The ideal candidate is a college graduate with a B.S. or B.A. in Math or Actuarial Sciences, ready for an entry-level position on the business side of healthcare.
NOTE: This is not a call center position
RECRUITMENT / HIRING OVERVIEW:
1. Online testing - approximately 35 minutes to complete
(**BONUS: We will send you a copy of your completed assessment candidate narrative so you get a behind-the-scenes view of the VALUE OF ASSESSMENTS in our recruitment and hiring process**)
2. Initial Zoom interview
3. Deeper Dive Zoom Interview + Skills Testing
4. Offer of Employment & Background Check
We will not discriminate in our employment and employment-related decisions against any applicant or employee based on age, race, gender, creed, religion, national origin, disability, marital status, covered veteran status, sexual orientation, status with respect to public assistance, membership or activity on a local commission, or any other characteristic protected under state, federal, or local laws.
Job Type: Full-time
About Patriot RN
Established in December 2010, we are a certified disabled veteran and small business subcontractor for long-term care claim validation and third-party benefits administrator.
Job Type: Full-time
Pay: Up to $18.75 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Education:
Language:
Shift availability:
Work Location: Remote
