Medical Claims Processor

Medical Claims Processor Diverse Lynx - 4.7 New York, NY Job Details Contract $34 - $36 an hour 16 hours ago Benefits Paid time off Referral program Qualifications Medical claims Insurance verification Medical insurance coverage verification ICD coding Analysis skills Health insurance Attention to detail Medical procedure terminology CPT coding Insurance (Financial sectors) Insurance claim processing Associate's degree Medical terminology Quality data entry Full Job Description Diverse Lynx LLC is actively hiring an experienced Claims Examiner for an exciting opportunity with MetroPlus Health Plan . We are seeking detail-oriented professionals with experience in medical claims processing, claims adjudication, and healthcare insurance operations . Position-Claims Examiner (Healthcare Insurance) |

Hybrid Client:

MetroPlus Health Plan Location:

50 Water Street, New York, NY 10004

Work Setting:

Hybrid Position:

Claims Examiner Employment Type:

Contract Opportunity Schedule:

Monday - Friday | 9:00 AM - 5:00

PM Hours:

35 hours/week

Patient Facing:

No Position Overview The Claims Examiner will be responsible for the accurate review, data entry, and adjudication of provider claims while ensuring compliance with established policies, procedures, and productivity standards. The ideal candidate will have prior healthcare insurance experience and a strong understanding of medical terminology, claims processing, and coding systems.

Key Responsibilities:

Process medical and surgical claims accurately and efficiently. Review member and provider information for completeness and accuracy. Perform data entry and adjudication of provider claims. Apply claims processing policies, procedures, and guidelines. Investigate and resolve contractual and payment discrepancies. Generate provider correspondence to obtain additional information when needed. Maintain departmental productivity and quality standards. Update reference materials and participate in ongoing training sessions. Perform other related duties as assigned. Required Qualifications Associate Degree or an equivalent combination of education and experience Minimum 2 years of healthcare insurance industry experience Experience with integrated claims processing Strong data entry skills Thorough knowledge of medical terminology Knowledge of CPT, ICD, and Revenue Codes Strong analytical, organizational, and problem-solving skills Excellent attention to detail Ideal Candidate Background Candidates with experience in the following roles are encouraged to apply:

Claims Examiner Medical Claims Processor Claims Adjudicator Healthcare Claims Specialist Claims Analyst Provider Claims Specialist Medical Billing & Claims Specialist Healthcare Insurance Specialist Pay:

$34.00 - $36.00 per hour

Benefits:

Paid time off Referral program

Education:

Associate (Preferred)

Experience:

healthcare insurance industry: 2 years (Required) Insurance verification: 2 years (Required) integrated claims processing: 1 year (Required) Ability to

Commute:

New York, NY 10004 (Required)

Work Location:

Hybrid remote in New York, NY 10004