Medical Claims Processor

Found in: Appcast Linkedin GBL C2 - 2 weeks ago


Atlanta, United States The Hird - USA Full time

Responsibilities:

  • Understanding and interpreting health plan benefits and determining patient eligibility
  • Maintaining patient confidentiality by Health Insurance Portability and Accountability Act (HIPAA) guideline
  • Handle taking new claims and provide basic claim customer service
  • Processes enrollment and eligibility changes from members and/or internal reports
  • Professionally handle requests from clients and ensure that issues are resolved both promptly and thoroughly
  • Setting up and updating claim information based on research and communication from members or providers
  • Assisting with the completion of various claims-related projects
  • Providing a high level of support and subject matter expertise within a fast-paced, intense, and high-volume claims operation where accuracy and quality are essential


QUALIFICATIONS

  • High School/ or equivalent required
  • 1 year of previous insurance claims processing experience
  • Understanding of health claims processing/adjudication
  • Ability to perform basic to intermediate mathematical computation routines
  • Medical terminology strongly preferred with understanding of ICD-9 & ICD-10
  • Typing speed of 22 wpm with 85% accuracy
  • Basic MS Office computer skills
  • Time management skills
  • Written and verbal communication skills
  • Attention to detail


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