Claims Processor

Job Description

Equitas Health does not conduct hiring through Telegram or WhatsApp and only communicates with candidates via official @equitashealth.com email addresses, requesting basic contact information only and never Social Security numbers during early hiring stages, with interviews scheduled via email and conducted through Microsoft Teams links only.

POSITION SUMMARY:

The Claims Processor is responsible for ensuring the accurate and timely submission of data into the Ohio Department of Health’s online third-party payer system for the payment of client medical expenses.

HOURLY RATE: $17.79 to $22.21 hr

ESSENTIAL JOB FUNCTIONS:

Essential functions of the job include, but are not limited to, data entry, typing, filing, sorting, utilizing a computer for data entry, conducting research, attending meetings, drafting and distributing reports, interacting with others, reconciling data, creating and updating spreadsheets, and coordinating multiple schedules. Communicating with others is an essential job function.

MAJOR AREAS OF RESPONSIBILITIES:

Ensure client medical bills are coded accurately according to the program fee schedule provided by ODH.

Enters client medical billing expenses into the online payment system within a 10-day turnaround timeframe from receipt of bill

Communicates effectively with Case Managers/Health Navigators and providers when needed to resolve any discrepancies in client medical bills and authorizations

Acts as main point of contact for providers regarding specific bills, payments, etc.

Researches billing information as needed by providers, case managers or supervisors

Assists in maintaining accurate and complete client files

Performs other duties as assigned

EDUCATION/LICENSURE:

Minimum of high school diploma or equivalent required

Knowledge, Skills, Abilities and other Qualifications:

Two years’ experience working with finance, billing, or insurance claims is preferred

Proficient with Microsoft Office (Excel, Word and Outlook), accounting software, and other applications

Must possess knowledge of accounting principles and practices

Excellent organization skills with an ability to prioritize and manage multiple tasks and a variety of demands and work efficiently without constant supervision.

Must have sensitivity to, interest in and competence in cultural differences, HIV/AIDS, minority health, sexual practices, and a demonstrated competence in working with minorities, and gay/lesbian/bisexual/transgender community.

Work well under pressure and ability to be flexible. Team player with strong communication and interpersonal skills.

OTHER INFORMATION:

Background and reference checks will be conducted. In accordance with Equitas Health’s Drug-Free Workplace Policy, pre-employment drug testing will be administered. Hours may vary, including working some evenings and weekends based on workload. Individuals are not considered applicants until they have been asked to visit for an interview and at that time complete an application for employment. Completing the application does not guarantee employment. EOE/AA

Full-time