Medicare Claims Processor

Job Summary

A company is looking for a Medicare Claims Processor to contribute to the foundation for an innovative health plan.

Key Responsibilities:

• Analyze and process Medicare insurance claims in accordance with CMS guidelines
• Resolve claim edits and determine benefit eligibility for services
• Maintain accuracy of data entry and record maintenance while meeting production and quality standards

Required Qualifications, Training, and Education:

• Associate Degree in a related healthcare field or high school diploma with 3 years of healthcare claims billing and processing experience
• At least 1 year of Medicare claims processing experience
• At least 1 year of experience working with CMS/professional and UB/institutional claims
• Working knowledge of Medicare medical insurance terminology and HIPAA requirements
• Customer service experience is required