Claims Processor

Job Summary

To support the claims department, the part-time remote Claims Processor will process new age claims, maintain aging reports, and ensure compliance with departmental standards while managing a high volume of claims daily.

Key responsibilities

• Data-enter and adjudicate internal and external claims in accordance with departmental policies
• Research and pend resubmitted or corrected claims while adhering to governmental guidelines
• Log claims for escalations and assist team members in achieving production goals

Required qualifications

• Two years of medical billing or claims processing experience
• Knowledge of CPT-4, ICD-9, HCPCS codes, and CMS 1500/UB04 forms
• Familiarity with Health Plan policies and/or AHCCCS regulations
• Ability to meet minimum production standards and process complex claims
• Experience with IDX claims system is preferred