Req #: 107085
Job Location(s): Brooklyn, NY
Zip Code: 11220
Status: Regular Full-Time
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Why work for MJHS?:
When you work with us you will receive comprehensive and affordable health and financial benefits, in addition to generous paid vacation, personal and holiday time that you won't find at our competitors. Do you receive a paid day off for your birthday now? No? You will here! You will also receive the training, tuition assistance and career development you desire to help you achieve your career goals. You take care of our patients, residents and health plan members, and we will take care of the rest!
- Sign-on Bonuses OR Student Loan Assistance for clinical staff
- FREE Online RN to BSN and MSN degree programs!
- Tuition Reimbursement for all full and part-time staff
- Dependent Tuition Reimbursement for clinical staff!
- Generous paid time off
- Affordable medical, dental and vision coverage for employee and family members
- Two retirement plans! 403(b) AND Employer Paid Pension
- Flexible spending
- And MORE!
Support the Claims Department unit for daily functions, project initiatives, and special projects as directed by the Claims Director or their designees. The projects will typically encompass developing and running ad-hoc reports, software implementations, system upgrades, and third party software modifications.
- HS diploma; Bachelor's Degree or Associates Degree in a health related field preferred
- Three to five years prior managed care experience in a health insurance company
- Experience working with technology, systems and IS departments
- Knowledge of ICD-9 and CPT-4 coding and medical terminology
- Knowledge of Medicare, Medicaid federal and state regulations as it pertains to claims processing
- Testing, data validation, and data flow experience is a plus
- Proficient in Windows, Word, Excel; Crystal and SQL
- Knowledge of Visio and PowerPoint a plus
- Excellent written and oral communications skills
- Technical experience or aptitude is essential
- Experience in Claims processing or IT environment is required
- Ability to interact with end users and foster cooperation is critical to the job
- Prioritization skills to handle multiple tasks aligning with claims management goals is essential to the job
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