We are hiring an experienced Claims Examiner to work with a very successful company in the Coral Gables, FL area.

We are interested in bringing an examiner into the claims department to resolve balance billing and appeals sent by clients, patients, and/or providers. This is an in-office position, working full time in Coral Gables, FL.

Responsibilities:
• Receive and register appeals/balance billing into the system (claim notes, image the documents in the patient’s file), spreadsheet and distribute according to department procedure.
• Review and determine, according to department procedure, how to resolve the appeal/balance billing.
• Handles, provider statements/invoices by contacting the providers to request complete claim forms
• Provide continuous update to both client and provider until appeals/balance billing is closed.
• Demonstrates the ability to communicate with others.
• Records complete, appropriate information in performing duties.
• Other office duties as assigned by Supervisor.

Qualifications:
- Recent experience processing commercial and PPO claims.
- ICD 9/10 and CPT coding knowledge is required.
- Must be able to work on-site in Coral Gables, FL
- Excellent communications skills.

If you're interested in taking your career to the next level with a successful company, apply today!

EEO/AA Employer/Vet/Disabled.

The Know Your Rights poster is available here:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf

The pay transparency policy is available here:
https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf

For temporary assignments lasting 13 weeks or longer, the Company is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.
https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf

We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.