You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a Claims Representative responsible for preparing and presenting response packages for arbitration, providing guidance on selection processes, creating scalable defense packages, ensuring process compliance, and delivering performance reports. The role requires a proactive approach to ensuring optimal success in claims settlement.

Key Responsibilities

• Prepare and present response packages for arbitration at both state and federal levels.
• Provide input on the selection process for certified arbitration entities under NSA.
• Create a scalable IDR defense package with improved automation.
• Ensure Claims Settlement processes adhere to privacy, compliance, legal, and HIPAA standards.
• Provide monthly performance reporting to leadership.
• Confirm all documentation meets compliance with required timelines and standards.
• Perform additional related responsibilities as assigned.

Qualifications

• 3 years minimum experience in claims settlement.
• Proficiency in Microsoft Office Suite, specifically Excel.
• Bachelor's Degree required.
• Experience with IDR and NSA.
• Ability to work without pre-scheduled time off for the first 90 days.
• Attention to detail and ability to meet established deadlines.

Experience

• Minimum 3 years in claims settlement.
• Experience with Excel and Microsoft Office Suite.

Skills

• Knowledge of the full Microsoft Office Suite.
• Strong Excel skills.
• Ability to work independently and as part of a team.
• Strong communication skills.
• Ability to work well under pressure and multitask.

Additional Requirements

• No pre-scheduled time off in the first 90 days.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the employee. The employee may be asked to perform other duties as required or directed.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients