Senior Claims Adjustor (On Site) - (Albany, NY)

Job DescriptionCareers at EmblemHealth: For 9 decades, EmblemHealth has been making quality health care accessible and affordable for New Yorkers, and helping to make life better in the communities we serve. Our employees are proud of that legacy and want to make health care better for everyone. Here we inspire success while helping employees build meaningful careers. We offer competitive health and welfare benefits, retirement benefits, and incentive compensation packages. Join us for a rewarding background.Responsibilities$18.28/PER HOUREvaluate medical claims that suspend within the Medical Claims System utilizing EmblemHealth's PPO proprietary conventional coding structure. Apply all PPO Coding & Pend desktop procedures during edit resolution.Correct claims as required for settlement utilizing established policies and procedures.Utilizing Claims Operation's C-More Adjudication Guidelines portal, reference QA memorandums, training guidelines, departmental memos, PRG's, etc.