Medical Claims / Repricing Associate

Berkshire Hathaway GUARD Insurance Companies•Wilkes Barre, PA

17d•Hybrid

About The Position

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!

Requirements

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

Responsibilities

Analyze billing information
Verification of ICD-10 and CPT-4 codes
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

Benefits

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 ½ 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!