Medical Claims Specialist

2 weeks ago


Johannesburg, Gauteng, South Africa St. John's Riverside Hospital Full time

Overview

St. John's Riverside Hospital is a leading healthcare provider dedicated to delivering exceptional patient care and advancing medical technology.

Career Opportunity

We are seeking an experienced Medical Claims Specialist to join our team in Yonkers, Westchester County. As a key member of our Business Office, you will play a vital role in ensuring seamless patient financial experiences.

Job Responsibilities:

Assist patients with navigating third-party benefits and insurance coverage.

Represent patients and families in applying for government programs, such as Medicaid and State Health Plans.

Conduct daily reviews of self-pay admissions for potential financial coverage.

Verify patient demographic and insurance information for accuracy.

Screen inpatients for insurance coverage and facilitate applications for Medicaid, QHP, and Health Solution programs.

Complete and process Medicaid applications in accordance with Department of Social Services guidelines.

Maintain communication with the Department of Social Services on pending Medicaid applications.

Perform clerical duties and other tasks assigned by management.

Requirements:

High school diploma or GED required; Associate degree in business preferred.

Excellent customer service and communication skills.

Proficiency in Word and Excel.

Proven analytical and problem-solving abilities.

Minimum 1 year experience in processing Medicaid applications.

Certified Application Counselor Certification required upon hire or within 90 days.

Bilingual English and Spanish preferred.

Compensation Package:

Our competitive salary range is $55,000 - $65,000 per annum, commensurate with experience.



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