Logo for network180

Claims Examiner (26-151)

Role overview

Summary

The Claims Examiner role focuses on the accurate processing and payment of claims within Network180’s provider network. This position supports the organization’s mission of delivering mental health and substance abuse treatment services in Kent County, ensuring that claims are handled efficiently and effectively.

Qualifications

  • High school diploma or GED and at least four years of medical billing, coding, and/or claims processing experience; or associate’s degree in health information technology or related field and two years of medical billing, coding, and/or claims processing experience.
  • Advanced computer skills including word processing, spreadsheets, database management, and email.
  • Knowledge of Medicaid, Medicare and third-party insurances.
  • Excellent communication skills, both verbally and written.
  • Excellent customer service skills.

Responsibilities

  • Process claims submitted by Network180’s provider network accurately.
  • Adjust and pay claims as necessary.
  • Analyze information and prepare spreadsheets and reports.
  • Communicate effectively with providers regarding claims.

Key facts

Hard skills

Other skills

  • Computer Literacy
  • Spreadsheets
  • Report Writing
  • Communication
  • Problem Solving
  • Customer Service
  • Time Management

About the company

network180 logo

network180

  • Mental & Behavioral Health
  • SME
  • 201–500
The community mental health authority for Kent County, Network180 connects adults, youth and families to services for mental health, substance use or intellectual & developmental disabilities.

Your match analysis

See how your profile stacks up against this role.

We compared the job requirements to your profile to show where you're strong and where you fall short.

Job description

Position: Claims Examiner
Req.#: 26-151
FTE: Full-time, non-exempt
Unit: UAW 
Department/Location: Revenue Cycle Services
Compensation: $21.99 - $29.15 The final job offer is based on several factors (internal equity, skills, education, experience, and credentials).

Attractive Benefits Package: Four health insurance plans | 100% employer paid dental and vision insurance plans | 13 paid holidays | Generous PTO | Professional development | Tuition reimbursement |Professional License reimbursement | Defined contribution retirement plan| Employee Assistance program | Life and voluntary life insurance options | Short and Long term disability | Approved site for loan forgiveness (based on position and department): NHSC, STAR Loan Repayment, Behavioral Health Loan Repayment, MI Kids Now Loan Repayment and much more!

Network180 employees make a difference in people’s lives every day, making our community a better place to live. We are the behavioral health community organization responsible for the delivery of mental health, substance abuse treatment coordination, and developmental disabilities services for Kent County. We need individuals who are passionate about making a difference by helping others. 

We are seeking a Claims Examiner responsible for accurate processing, adjustment and payment of claims submitted by Network180’s provider network.   

This position is 40 hours a week, Monday through Friday, 8:00 am to 5:00 pm. There are no weekends, on-call, or holiday requirements for this position. This is s Michigan based remote position. Candidates must reside in the state of Michigan and be available to attend in-person meeting in Kent County, Michigan, as needed.

MINIMUM QUALIFICATIONS: 

•    High school diploma or GED and at least four (4) years of medical billing, coding, and/or claims processing experience; or associate’s degree in health information technology or related field and two (2) years of medical billing, coding, and/or claims processing experience. 

•    Advanced computer skills including word processing, spreadsheets, database management, and email.

•    Knowledge of Medicaid, Medicare and third-party insurances.

•    Skills and experience in analyzing information and preparing spreadsheets and reports.

•    Ability to prioritize tasks and manage time in an effective and efficient manner.

•    Excellent communication skills, both verbally and written. 

•    Excellent problem-solving techniques.

•    Excellent customer service skills.

•    Lived experiences with mental illness/developmental disabilities/substance use disorders valued.

Job interviews are being conducted in person or via the internet. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed on the job description are representative of the knowledge, skill, and/or ability required.  For a detailed job description and responsibilities please review the job description.  Network180 is an Equal Opportunity Employer. Network180 participates in E-Verify. 

Network180 is a drug and alcohol-free workplace, which includes the prohibition of recreational marijuana use. Successful completion of a drug screen is part of our background check process.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Assistance with the application process may be requested through the Human Resources Department at 616 336-3909 or jobs@network180.org. 

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.

Related jobs

See all Insurance Claims Examiner jobs

Other jobs at network180