Medical Benefits Reviewer

Job Summary

Reviewing and resolving system edits on pended Medicaid Claims, the full-time Medical Benefits Reviewer will work remotely to ensure accurate processing of claims submitted through CHAMPS.

Key responsibilities

• Review and resolve edits on pended Medicaid Claims billed on the UB04 Claim Form
• Process medical benefits claims and ensure compliance with relevant regulations
• Document relevant experience and education thoroughly for application screening

Required qualifications

• High school diploma or equivalent educational level
• Two years of administrative support experience, including one year as a Medical Benefits Reviewer 6
• Possession of a certificate from a Medical Assistant program may substitute for one year of experience processing medical claims