3 days ago
Claims Examiner will be responsible for adjudicating complex claims, manually and/or automatically priceclaims accurately, and identify billing issues.
Responsibilities include, but not limited to:
• Bachelor’s degree in related field or AA degree with related experience
• Must have at least 3 years of applicable healthcare claims adjudication experience within a managed care industry
• Must be familiar with ICD-9, HCPCS, CPT coding, APC, ASC, and DRG pricing.
• Must be familiar with facility and professional claim billing practices.
• Must have good written and communication skills.
• Must be able to follow guidelines, multi-task, and work comfortably within a team-oriented environment.
• Computer literacy required, including proficient use of Microsoft Word, Excel, Outlook, and EZ-CAP. Crystal Report is a plus.
• Typing skills of at least 40 wpm.