Hi All,

Please send your best consultants immediately. Looking forward to your response.

 
Job Title: 5 spots/BA/Diamond claims Exp

Location: Silver spring MA or Portland OR or Denver CO

Duration: 12+ months 


 
Descripton:
 

Basic Qualifications: 
. Bachelor's degree in business, health care or other applicable field or 4 
additional years of equivalent experience 
. 3 years experience in health insurance or managed care environment 
. 3 years experience in claims processing/resolution 
. 2 years of the any of following: membership, benefits, provider contracts & 
pricing, medical reviews, referral authorizations and code review and fee 
schedules 
. Demonstrated ability to research, analyze, design, plan, organize, 
coordinate, implement, and perform necessary follow-up and closure procedures 
for system related deliverables 
. Understand relational databases 
. Strong experience in documentation, research and reporting 
. Strong analytical and problem solving skills 
. Excellent interpersonal, communication, & listening skills 
. Proficiency in medical terminology, medical coding (CPT4, ICD9, and HCPCS), 
provider contract concepts and common claims processing/resolution practices 
. Intermediate proficiency in Excel 

Preferred Qualifications: 
. Three to five years experience in system design and analysis (provider 
contract or benefits administration) 
. 2 years experience on the host claims processing system Diamond 
. Experience interpreting and relaying Health Plan benefits and services 
. Experience in systems testing or user acceptance testing 
. Knowledgeable of state and federal regulations 
. Beginner's proficiency in Access and Query tools 
 
Warm Regards,
Shirly
Amtex Systems Inc.
"Certified Minority Business Enterprise firm"
Amtex Systems Inc is rated among the top privately held Technology companies in 
New York.
50 Broad Street, Suite 801       
New York, NYC-10004
www.amtexsystems.com 
Direct:    646-201-4044
Fax:       866-330-0589
Email: [email protected]

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