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Insurance Claims / Policy Clerk
Ewing Township, NJ
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There's never been a better time to join NJM! With a nationally ranked reputation for outstanding customer service and a history that spans more than a century, NJM is a leading provider of worker's compensation, automobile and homeowners insurance in New Jersey. Our MCS (Medical Claims Services) Medical Bill Processing Department has an opening for a Bill Processor and is seeking a candidate who has excellent communication skills as well as strong organizational and time management skills. Reporting to a Supervisor in Medical Claim Services Bill Processing, the Bill Processor (BP) is responsible and accountable for the timely audit and processing of medical bills. Timely and accurate processing is vital to ensuring that medical bills meet all regulatory timeframes.
Schedule:
Monday-Friday, specific hours are subject to selected start times between 8:00am-9:00am pending supervisory approval. (Potential for hybrid schedule once fully trained.)
Essential Duties and Responsibilities:
Essential functions of this job are listed below in order of priority. Reasonable accommodations may be made to enable individuals to perform the essential duties. Regular and predictable onsite attendance is an essential function of the job Accurately audit and process standard medical bills for routine procedures within statutory timeframes, by following medical coding guidelines and department policies and procedures Verify correct payee and provider information and ensure all bills that meet audit criteria are routed immediately for audit purposes. Communicate with claims personnel relating to complex issues regarding authorizations, pre-certifications and compensability. Apply state fee schedules when appropriate Demonstrate working knowledge of the available computer systems (imaging, bill processing, claims) to insure prompt and accurate bill processing. Research and respond by telephone/email to provider inquiries regarding billing issues in a timely manner
Required Qualifications:
Knowledge, skills & abilities, experience, minimum & desired education, certification and/or license requirements. High School Diploma or GED required Associate Degree and/or coding certification, preferred 1-2 years of insurance and/or medical office experience, preferred Strong communication skills, including writing, speaking and active listening Ability to learn quickly, work in fast paced environment and adapt to change Organization, time management and prioritization abilities Strong interpersonal and customer service skills Ability to balance priorities by responding to customer concerns while performing thorough investigations of all issues encountered Knowledge of CPT (Current Procedural Terminology) and ICD-10 codes a plus Multi-state knowledge for Workers' Compensation and/or Personal Auto (PIP) a plus Multi-tasking, problem-solving and decision-making abilities Effective computer skills and ability to work in multiple systems Ability to work independently
Salary Range:
$42,577 - $49,488. Salary is commensurate with experience and credentials.
Benefits Offered:
Medical Insurance (Blue Cross Blue Shield) Dental Insurance (Delta Dental) Vision (Delta Vision/ VSP) Flexible Spending Account Discounts on NJM auto insurance Tuition reimbursement Life insurance Plus, additional company discounts for items like travel, service, car rental and more!
Legal Disclaimer:
NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.
Job Type:
Full-time Pay:
$42,577.00 - $49,488.00 per year
Benefits:
401(k) 401(k) matching Dental insurance Employee discount Flexible spending account Health insurance Paid time off Tuition reimbursement Vision insurance Ability to
Commute:
Ewing, NJ 08628 (Required) Ability to
Relocate:
Ewing, NJ 08628: Relocate before starting work (Required)