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Laiza Lagarto
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Recruiting Manager at Quality Staffing of America

URGENT HIRING: CLAIMS BENEFITS SPECIALIST AT AETNA (ORLANDO, FL)

Location: 503 Sunport Lane Orlando FL 32809 Pay Rate: $15.50/hr. Duration: 4-month contract to start off Shift hours: M-F, needs someone flexible between 8am-8pm Tentative Start Date: 03/26/18

Role/Responsibilities: • Review and work aging reports to identify delay in payments and past due balances, averaging 50 to 75 claims worked per day • Perform Reimbursement Medicare & Medicaid Billing and Collections • Review and research all denied claims by referencing patients’ Explanation of Benefits and prior authorization • Correct and rebill claims as required • Review all payer correspondence, submits and monitors detailed Medicare & Medicaid appeals to insurance companies. Timely response to Medicare remediation, denials letters received. • Appeals: Write appeals to insurance companies to overturn pending, incorrect reimbursements, or denied bills, fee schedule appeals • Identify if accounts that have been either under or over paid • Supports the billing of medical receivables by ensuring effective and accurate timely Medicare & Medicaid payer billing • Documentation: Obtain necessary information (updated diagnosis codes, billing codes, claim numbers, dates of injury, claims addresses etc ) and submit to insurance carrier to affect payment of claim. • Computer skills: Excel, word, CPR+ • Greet and transferred calls to the proper department • Create Transplant files and ensuring follow up of medical chart records are tracked and received timely

Background/Experience Requirements: • 1-2 years or more of experience of collection practices • Understand pharmacy/medical terminology • Proficient with all Microsoft Office Platforms

Interested in Being Considered? Reach out to Laiza Lagarto and send your updated resume at recruiters7@qualitystaffingamerica.com for immediate consideration. APPLY NOW!

2 Comments
over 8 years ago
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Ashok Rajendran
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Dr.

Hello Laiza,

I am Ashok from India completed my doctorate degree ( pharm D ).... Nice to meet you.. I am interested to join your team and start my work immediate if I get a chance, Also at present I am in India, mayI know am I eligible to apply for the above job. Thank you.

8y
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Marcus Jordan
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Career Specialist at Jobcase

Sounds like a solid foot in the door towards something bigger. Thanks for sharing Laiza, we'll get the word out.

8y
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