Claims Processor

Location: Remote
Compensation: To Be Discussed
Staff Reviewed: Wed, Jul 10, 2024
This job expires in: 27 days

Job Summary

A company is looking for a Claims Processor.

Key Responsibilities:
  • Data-enter and adjudicate internal and external claims in accordance with policies and procedures
  • Research and pend resubmitted or corrected claims, adhering to governmental guidelines
  • Troubleshoot and resolve special handling requirements related to pricing, contracting, and system issues

Required Qualifications:
  • Minimum of two years of medical billing or claims processing experience
  • Knowledge of CPT-4, ICD-9, and HCPCS codes, as well as CMS 1500 and/or UB04 forms
  • Good decision-making skills and ability to meet production standards
  • Knowledge of Health Plan policies and/or AHCCCS regulations and IDX system
  • Ability to research and process complex claims

COMPLETE JOB DESCRIPTION

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