Job Summary
A healthcare technology provider has a current position open for a Remote Medical Claims Management Examiner.
Must be able to:
- Accurately analyze and interpret provider contracts
- Evaluate claims for completeness and validity to determine payment/denial according to provider contracts
- Processe various Medicare and Medicaid claim types, including Professional, Facility and Dental claims
Skills and Requirements Include:
- Two years of claims processing experience with an insurance company or TPA is required
- Requires knowledge of current computer technology
- Educational requirements include a high school diploma or equivalent
- Requires working knowledge of ICD-10, CPT, Revenue, and HCPCS coding, along with understanding of APC and DRG reimbursement
- Skilled in establishing and maintaining effective working relationships with co-workers and clients
- Skilled in problem resolution; recommends suggestions to increase accuracy and/or efficiency
