We are seeking a detail-oriented, independent individual with: 

• High school diploma, GED, or equivalent.
• Minimum of 2 years of medical claims customer service experience in an HMO environment (e.g., MSO, IPA, or health plan).
• Proficient with CPT/HCPC codes, UB04, 1500 forms, ICD-10, ASA, Medicare Guidelines, and COB.
• Extensive knowledge of professional and facility reimbursement methodologies and benefit determination.
• Demonstrated competence in medical terminology and claims adjudication systems.
• Able to handle a high volume of calls and work under pressure.
• Proficient computer skills, including Microsoft Word and Excel.
• Independent worker with the ability to meet deadlines and production standards.
• Flexible, adaptable, and goal-oriented, capable of multitasking and working with frequent interruptions.