Healthcare Claims Processor

Job Summary

A company is looking for a Healthcare Claims Processor to support a leading health insurance customer.

Key Responsibilities

• Review and adjudicate paper/electronic claims for complex medical cases
• Conduct regular audits and generate weekly Claims Resolution reports for management
• Schedule meetings with provider groups to address claim resolution issues and handle provider communications

Required Qualifications

• High school education with at least 2 years of experience in claims or a related field
• Knowledge of FACETS v. G6, Microsoft Excel, Adobe PDF, ICD-10, and Medicaid
• Must possess a personal laptop or PC
• Ability to disclose any debarment or exclusion from Federal health care programs