| Company: |
Horizon NJ Health |
| Location: |
Newark, NJ, USA |
| Type: |
Full-Time |
| Salary: |
$55400 - $74130 |
Requirements
- High School Diploma/GED required
- Requires a minimum of four (4) years of experience in claims processing
- Strong knowledge of medical terminology required
Responsibilities
- Support Horizon Legal staff with cases (ex: Third Party Liability claims, Medical Malpractice claims, Workers Compensation Claims, Class Action Lawsuits, etc.) where Horizon has been impleaded.
- Respond to weekly requests from vendor (ex: Summary Plan Documents, Claim Purge Request, Form 5500, etc.).
- Audit reimbursement reports to resolve issues and create and submit appropriate reports for management review.
- Prepare materials and documentation to assist with internal and external audits as requested.
- Review and update group language documents to include the appropriate reimbursement rights and create training materials to support procedural changes.
- Assist in monitoring and testing system changes to ensure accuracy.
- Mentor junior and temporary staff through coaching and training. Participate in meetings and workgroups as necessary.
- Perform other duties as requested by Management.
Preferred Qualifications
- Third Party Liability experience preferred
- Knowledge of Subrogation/Workers Compensation Regulations and Laws preferred
Benefits
- No benefits info provided.
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