Medical Claims / Repricing Associate
US-PA-Wilkes Barre
careers
Req #: 5754
Type: Regular Full-Time
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Overview: Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ "Superior" by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! * Competitive compensation * Healthcare benefits package that begins on first day of employment * 401K retirement plan with company match * Enjoy generous paid time off to support your work-life balance plus 9 paid holidays * Up to 6 weeks of parental and bonding leave * Hybrid work schedule (3 days in the office, 2 days from home) * Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) * Tuition reimbursement after 6 months of employment * Numerous opportunities for continued training and career advancement * And much more! Responsibilities: The Medical Claims/Repricing Associate is an integral part of our Workers' Compensation department and will be responsible for analyzing billing information, verification of ICD-10 and CPT-4 codes, and submission of reconsiderations. * Research, respond, and track inquiries in a timely manner that come into the Provider Relations mailbox * Conduct quality assurance on invoices * Provide customer service for our providers (Doctor Offices & Hospitals) * Answer inbound calls from external medical providers * Have the ability to work within turnaround time standards so claims team can meet prompt pay claim requirements per State Law * Have the ability to review proper coding ICD-10, CPT, and HCPCS codes Qualifications: Required: * Solid understanding of medical coding (ICD-10, CPT, HCPCS) * Knowledge of workers compensation state rules and regulations * Strong attention to detail, organizational and problem-solving abilities * California adjuster's license (must be willing to obtain at the company's expense following time of hire) * High School Diploma/GED
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