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At MVP Health Care, we’re on a mission to create a healthier future for everyone – which requires innovative thinking and continuous improvement. To achieve this, we’re looking for a **Senior Medical Claims Examiner** . If you are a team player with a passion for health care and attention to detail this is the opportunity for you.

What’s in it for you:

+ Growth opportunities to uplevel your career

+ A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team

+ Competitive compensation and comprehensive benefits focused on well-being

+ An opportunity to shape the future of health care by joining a team recognized as a **Best Place to Work For in the NY Capital District** , one of **the Best Companies to Work For in New York** , and an **Inclusive Workplace** .

Qualifications you’ll bring:

+ AAS degree with claims experience preferred, or equivalent combination of education and experience will be considered.

+ The availability to work Full-Time, Virtual within New York State

+ Two years’ experience processing health insurance claims required.

+ Knowledge of CPT, HCPCS, ICD-9-CM coding systems and Medical terminology preferred.

+ Strong PC skills required, Microsoft Windows experience highly desired. Strong attention to detail.

+ Ability to prioritize multiple assignments with attention to details and deadlines in a high-volume environment.

+ Curiosity to foster innovation and pave the way for growth

+ Humility to play as a team

+ Commitment to being the difference for our customers in every interaction

Your key responsibilities:

+ Provide feedback to the unit leader on daily activities and priority issues

+ Act as the point person for each unit and handle E-mail, internal and corporate service forms, and phone inquiries

+ Monitor and assist with the distribution of SF’s and E-mail correspondence for claim corrections

+ Calculate daily production goals for each unit and review aged claim reports

+ Run reports showing the daily production numbers of each examiner and produce weekly and monthly unit production reports

+ Analyze claims processing trends and create reports from Facets system selects and downloads

+ Specialize train new and existing claims examiners and forward new claim procedures, processes, and information

+ Provide routine call coaching/question time to E-workers and review quality control appeals

+ Responsible for outbound calls/faxes to provider offices for our member submitted claims.

+ Reviews quality control on claims as well as appeals. Will work with Quality Assurance on any discrepancies on errors between the examiners and makes first line decisions regarding the outcome of appeals.

Where you’ll be:

Virtual within New York State, preferably Schenectady, Rochester, or Tarrytown

Pay Transparency

MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.

We do not request current or historical salary information from candidates.

MVP's Inclusion Statement

At MVP Health Care, we believe creating healthier communities begins with nurturing a healthy workplace. As an organization, we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger, and our unique perspectives are catalysts for creativity and collaboration.

MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications.

To support a safe, drug-free workplace, pre-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at [email protected] .

Job Details

Job Family** **Claims/Operations

Pay Type** **Hourly

Hiring Min Rate** **23 USD

Hiring Max Rate** **27 USD