Medicare Claims Processor

Job Summary

A company is looking for a Medicare Claims Processor to analyze and process insurance claims in accordance with CMS guidelines.

Key Responsibilities

• Ensure accuracy of data entered and maintain records
• Analyze claims to determine insurance carrier liability and resolve claim edits
• Review payment levels and adjudicate claims following Medicare processing guidelines

Required Qualifications

• Associate Degree in a related healthcare field or high school diploma with 3 years of healthcare claims billing experience
• At least 1 year of Medicare claims processing experience
• 1 year of experience with CMS/professional and UB/institutional claims
• Working knowledge of Medicare terminology, procedure, diagnosis codes, and HIPAA requirements