Adjudication, Claims Processing, Communication Skills, Content Management Systems (CMS), Customer Support/Service, Data Entry, HIPAA (Health Insurance Portability and Accountability Act), Healthcare Providers, Information/Data Security (InfoSec), Insurance Claims, Network Configuration Management, Problem Solving Skills, Provider Relations, Quality Assurance, Time Management, United States Department of Defense (DoD)
9141569- Claims Examiner Irving, TX 3 Months contract
Sigma Inc. is currently looking for a Claims Examiner in Irving, TX.
Shift Timings: Mon-Fri 40 hours per week
Summary:
- The Claims Examiner is responsible for processing UB and CMS 1500 claims, performing data entry and claim pend issue resolution within the quality and production requirements
- This role works in conjunction with Business Configuration, Network Management, Provider Data, Complaints, Appeals and Grievances as well as other operational departments to ensure validation and quality assurance of claims processing.
Responsibilities:
- Adjudicate claims at a rate equal to 150 per normal workday
- Maintain statistical accuracy of 98%, and financial accuracy of 98%
- Correct DoD error report as needed, respond timely to all Customer Service, Provider Relations type questions
- Other duties as assigned by management
- Collaborate with and maintain open communication with all departments within CHRISTUS Health to ensure effective and efficient workflow and facilitate completion of tasks/goals
- Follow the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI)
Job Requirements: