Affinity Medical Solutions
Affinity has an exciting opportunity for a Claims Examiner III. This position is responsible for independently reviewing, adjudicating and finalizing Provider Dispute Resolution (PDR) requests, processing claims adjustments requests received from Customer Service, and adjudicating special projects claims. Research and review necessary documentation and apply claims policy appropriately and accurately in order to resolve and finalize claims adjustment requests. Process professional and institutional electronic and paper medical claims. Meet established Claims department claims processing quality and production performance benchmarks. Effectively manage workload and prioritize assignments. Work without significant guidance. Ensures claims adjudication is in accordance with State, Federal and Health plan regulatory requirements as well as departmental guidelines.
We invite you to send your resume and cover letter to email@example.com. Please include "Claims Examiner III" in the subject line.
Equal Opportunity Employer