JOB SUMMARY:

The primary purpose of this position is to examine & process claims from the UB04 & CMS-1500 claim forms into the claims adjudication system for all capitated & shared services accounts. This position is responsible for the accurate review, input & adjudication of claims using payment policies & methodologies that are consistent with and recognized by Health Plans nationally recognized medical organizations federal regulatory bodies & contractual obligations of the organization.

SKILLS REQUIRED:

- Excellent critical thinking skills

- Strong decision-making ability

- Administrative and interpersonal skills

- Outstanding customer service skills

- Ability to work under pressure

MINIMUM QUALIFICATIONS:

High School Diploma, G.E.D. or Equivalent

Two years of experience

PREFERRED QUALIFICATIONS:

Three years of experience

The current salary range for this position is $23.10 to $31.77

Rady Children’s Hospital is committed to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity. This posting will remain open from the “date posted” until the hiring manager has determined there is a sufficient applicant pool or until the position is filled.