Medical Claims Processor
Found in: Appcast Linkedin GBL C2 - 2 weeks ago
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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