Claims Analyst

Lake Worth FL


Praesum Healthcare

Job #


Job Type

Full Time

Job Description

Praesum Healthcare:
Claims Processing Clerk

Founded in 2003, Praesum Healthcare provides administrative services for healthcare providers spanning key geographical locations throughout the country. Praesum has serviced over 49,000 patients in various stages of health care services. With an established business model, strong finances, expert industry management team, and proven networking capabilities, Praesum looks to prosper in the $11.6 billion industry (2014 industry revenue forecast). Separate from its networks of providers, Praesum currently runs and operates eight drug and alcohol detoxification centers in Florida, New Jersey, Georgia and Massachusetts, as well as ten outpatient counseling centers in New Jersey and New York.

Job Description:
The Admissions Coordinator is a vital member of the Detox and Emergency Care component of the System of Care. This person must have knowledge of addictions. The ability to interact with a multi-disciplinary team to assist in facets of the recovery program relating to physical health. Knowledge of the 12-Step Recovery Program. Knowledge and competency in problem solving, stress management, ethics and team building.

• Review and audit medical records for accuracy in billing, coding and insurance requirements
• Organize and manage patients' health information data
• Prepares daily charges and claims to be submitted electronically to clearing house and insurance carriers
• Accounts Receivable follow up with insurance carriers
• Claim denial management with electronic clearing house
• Utilizes 3 different code sets: CPT, HCPCS, and ICD-10 for appropriate billing to insurance carriers
• Release information to persons and agencies according to state and federal regulations
• Possess the ability to critically analyze documentation, assigning proper codes.

• High School Diploma or GED equivalent required, AA Degree or Vocational training preferred
• A minimum of 2 years of office or related healthcare industry experience
• Working knowledge of Microsoft Office applications

• Full Time
• Monday - Friday

• Hourly rate competitive with experience and location

Full time employees may be eligible for the following:
• Medical Insurance
• Dental/Vision Insurance
• $25,000.00 Basic Life Insurance
• 401k
• Accrued PTO Plan
• Education reimbursement

*** This job does NOT sponsor visa's and we are unable to consider out of country applicants ***

If you are interested in this opportunity or know someone that you respect who would be a good fit for this position, please email: Director of Talent Acquisition, Chase Executive Recruiter, Ray