Claims Examiner (Pay rate: $30-$31/hr.) New York, NY

Job Description

Job Description

Please find below the Job Description:

• Job Title : Claims Examiner/Claims Processor / Claims Adjudicator (Healthcare Insurance)
• Duration : 3-6+ months possibility for extension more
• Location : New York NY (Hybrid)
• Pay Rate : $30/Hr.

 

Job Summary

We are seeking a detail-oriented Claims Processor to review, evaluate, and adjudicate healthcare claims accurately and within defined guidelines. The ideal candidate will have experience in medical claims processing and strong knowledge of coding systems and insurance policies.

Key Responsibilities

• Process and adjudicate medical and surgical claims in a timely manner
• Verify completeness and accuracy of member and provider information
• Apply claims processing guidelines, policies, and procedures
• Identify errors, discrepancies, or invalid charges on claims
• Review and resolve system-pended claims
• Initiate communication with providers to obtain additional information when required
• Meet productivity and quality benchmarks
• Maintain accurate records and participate in training and process updates

Required Qualifications

• Associate’s degree or equivalent combination of education and experience
• Minimum 2 years of experience in healthcare insurance or claims processing
• Strong data entry and analytical skills
• Good understanding of medical terminology, CPT, ICD, and revenue codes

Preferred Skills

• Experience with integrated claims processing systems
• Strong attention to detail and problem-solving ability
• Good communication and organizational skills

Benefits:

Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, , legal support, auto ,home insurance, pet insurance, and employee discounts with preferred vendors.

Company Description

Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, pet insurance and employee discounts with preferred vendors.

Equal Employment Opportunity
Pride Health is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.

Fair Chance Employment
Pride Health is a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.

Accommodations
We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.

Only applicable for San Francisco Candidates: Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.

Only applicable for Kentucky positions: For this type of employment, state law requires a criminal record check as a condition of employment. This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793.

Company Description

Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, pet insurance and employee discounts with preferred vendors.\r\n\r\nEqual Employment Opportunity\r\nPride Health is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.\r\n\r\nFair Chance Employment\r\nPride Health is a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.\r\n\r\nAccommodations\r\nWe are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.\r\n\r\nOnly applicable for San Francisco Candidates: Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.\r\n\r\nOnly applicable for Kentucky positions: For this type of employment, state law requires a criminal record check as a condition of employment. This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793.