Medical Claims / Repricing Associate

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!Benefits:We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You’ll be surprised by all we have to offer!Competitive compensationHealthcare benefits package that begins on first day of employment401K retirement plan with company matchEnjoy generous paid time off to support your work-life balance plus 9 ½ paid holidaysUp to 6 weeks of parental and bonding leaveHybrid 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 employmentNumerous opportunities for continued training and career advancementAnd much more!The Medical Claims/Repricing Associate is an integral part of our Workers' Compensation department and will be responsible for analyzing billing information, verification of ICD-10 and CPT-4 codes, and submission of reconsiderations.Research, respond, and track inquiries in a timely manner that come into the Provider Relations mailboxConduct quality assurance on invoicesProvide customer service for our providers (Doctor Offices & Hospitals)Answer inbound calls from external medical providersHave the ability to work within turnaround time standards so claims team can meet prompt pay claim requirements per State LawHave the ability to review proper coding ICD-10, CPT, and HCPCS codesRequired:Solid understanding of medical coding (ICD-10, CPT, HCPCS)Knowledge of workers compensation state rules and regulationsStrong attention to detail, organizational and problem-solving abilitiesCalifornia adjuster's license (must be willing to obtain at the company's expense following time of hire)High School Diploma/GED

Created: 2025-12-15