Posted 4 days ago
Accounts Payable Claims Adjudicator
Gulfside Healthcare Services
Requirements
High School diploma or GED, 1 year related experience, CMS-UB04 and CMS-1500 experience, Medical terminology knowledge
Skills
AP/AR
About the role
Responsibilities
- Analyze and adjudicate various claim types, including facility, professional, inpatient, and outpatient services
- Interpret contract benefits and follow adjudication rules to ensure compliance with CMS regulations
- Review Medicare, Medicaid, and Commercial payer contracts and timeliness guidelines
- Support accounts payable activities to ensure accurate and timely processing
- Complete coding and record accounts payable entries
- Process refunds, appeals, disputes, and adjustments
- Identify and recommend process improvement opportunities
Requirements
- High School diploma or GED equivalent
- Minimum of one year of related experience
- Experience with CMS-UB04 (institutional) and CMS-1500 (professional) claims
- Ability to calculate figures and co-insurance amounts
Preferred Qualifications
- Associate’s degree in a related field
- Previous experience in medical or insurance environments
- Familiarity with medical terminology, procedure codes, and diagnosis codes
About the Company
Gulfside Healthcare Services provides essential healthcare services and is committed to equal employment opportunity and workplace excellence.
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Gulfside Healthcare Services · Land O Lakes
