NuWest Group · 2 hours ago
Claims Specialist
Renton, WA
Full-time
Hybrid
Entry, Mid Level
$25/hr - $30/hr
2+ years expNuWest Group is seeking a Claims Specialist to adjudicate claims submitted by outside purchased services for their enrolled capitated population. The role involves adjusting complex claims and responding to customer service requests to resolve problem claim situations.
CRMInformation Technology
Responsibilities
Adjudicates claims submitted by outside purchased services for PMC's enrolled capitated population and communicates those actions
Adjusts complex claims for advanced processing needs
Responds to Customer Service Requests and resolves problem claim situations
Qualification
Required
H.S. Diploma or GED or equivalent experience in Health Care Business Administration
2 years in Managed Care operations
1 year of Claims processing experience, in a TPA, MSO, HMO, PHO or large group practice setting
Experience with areas of specialty claim processing (COB, Adjustments, Point of Service, Home Health and Encounters)
Information systems supporting the administration of managed care products
Preferred
IDX healthcare software application
CHAMPUS, Medicare and/or Medicaid benefits/programs
Company
NuWest Group
At NuWest Group, we pride ourselves on providing the highest level of customer service to our clients and candidates.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Traci Danek
President
Company data provided by crunchbase