Job Title: Accounts Payable Assistant / Claims Examiner
Location: New York, NY 10004
Duration: 04/27/2026 – 06/20/2026
Shift: 9:00 AM – 5:00 PM
Schedule: 5 days/week, 7 hrs/day, 35 hrs/week, No on-call
Schedule Notes: Monday–Friday; Hybrid work setting; Non-patient facing; Minimum 2 years healthcare insurance claims processing experience required; Integrated claims processing knowledge required; Intermediate PC applications required; Decision-making, problem-solving and time management skills required
Work Setting: Managed Care / Health Plan (Non-Patient Facing)
Pay Range: $25-$28/hr.
Requirements
Required Skills & Experience
- Minimum 2 years of experience in the healthcare insurance industry with integrated claims processing knowledge
- Experience processing provider medical and/or surgical claims
- Experience with system adjudication and claims examination
- Proficient data entry skills
- Knowledge of medical terminology, CPT, ICD coding, and Revenue Codes
- Ability to review claims for errors, payment discrepancies, and validity of charges
- Experience applying claims processing manuals and administrative policies
- Ability to authorize provider correspondence and request additional claim information
- Ability to maintain production and quality goals in a high-volume claims environment
- Experience auditing clinical claims and updating reference materials
Education
- Associate Degree or equivalent combination of education and experience required
Certifications & Licensure
- None
Job Summary
Responsible for data entry and system adjudication of provider claims, authorizing final claim disposition within prescribed guidelines while ensuring accuracy, compliance, and timely processing.
Job Responsibilities
- Process medical and surgical provider claims
- Screen claims for complete member and provider information
- Apply administrative policies and claims processing manuals
- Review claim services for validity of charges and errors
- Evaluate claims pended due to contractual or payment discrepancies
- Authorize provider letters/questionnaires for additional information
- Maintain departmental production and quality standards
- Maintain production counts and update manuals/reference materials
- Attend refresher training seminars
- Perform related duties as assigned