Simplify Logo

Full-Time

Claims Examiner

Confirmed live in the last 24 hours

Welbe Health

Welbe Health

501-1,000 employees

Comprehensive elderly care and support services

Consumer Goods

Compensation Overview

$66.6k - $67.1kAnnually

Mid

Remote in USA

Category
Quality Control & Compliance
Operations & Logistics
Requirements
  • Minimum of three (3) years of experience with processing, researching, and adjudicating claims in a complex managed care environment
  • In depth experience with Medicare and Medicaid claims processing (professional & institutional claims)
  • Demonstrated skills within Microsoft Office Applications & electronic claims processing systems
Responsibilities
  • Assess appropriateness of returned, denied, or paid claims by reviewing and following contractual obligations, federal and state regulations, organizational policies and procedures, or other established quality standards
  • Work alongside manager to establish and maintain claims processing rules that meet all regulatory and business requirements
  • Assist internal and external partners with questions related to claims decisions or claims statuses

WelbeHealth offers a full-service Program of All-Inclusive Care for the Elderly (PACE), providing medical care, coordination, home care, dental, transportation, physical therapy, prescriptions, social activities, and meals, often at no cost to eligible seniors. The product is supported by a dedicated technology development effort led by experienced leaders from leading payer and provider organizations.

Company Stage

Series C

Total Funding

$61.2M

Headquarters

Menlo Park, California

Founded

2015

Growth & Insights
Headcount

6 month growth

6%

1 year growth

21%

2 year growth

69%