Full Time Johnstown, Pa
Senior LIFE is an innovative home and community based Medicare and Medicaid funded program which provides all-inclusive healthcare services and support to seniors living in the community. Senior LIFE makes it possible for seniors to remain at home, enjoying the comfort and reassurance of familiar surroundings while receiving the care they need. Senior LIFE staff live the mission of the program. Our team is committed to partnering with our seniors to remain at home through promoting open communication and shared decision making while providing excellent care and services.
To fulfill this mission, Senior LIFE is seeking hardworking, dedicating and compassionate professionals to join its team. Within this team, the LIFE Center is seeking a talented, experienced Claims Processor.
The responsibilities including:
Processing of medical claims (Outpatient Hospital, Physician, DME, Pharmacy, Ambulance, etc.)
Verification of Provider contract language for accurate payment adjudication.
Weekly claims adjudication/balancing for claims payment.
Verification of referrals obtained for services
Preparation of member enrollments for state agency
Field incoming phone calls regarding claim questions/claim status
Other billing-based duties, as needed
This position requires a versatile, independent and detail-oriented professional. Prior claims processing experience is preferred. Working knowledge of Microsoft Word and Excel.