Insurance Claims Examiner

1 week ago


San Antonio, Texas, United States University Health System- San Antonio Full time
Job Summary

We are seeking a highly skilled Insurance Claims Examiner to join our team at University Health System- San Antonio. As an Insurance Claims Examiner, you will be responsible for reviewing accounts to ensure accurate reimbursement and identifying payor issues affecting payment delays.

Key Responsibilities
  • Review accounts to ensure accurate reimbursement and identify payor issues affecting payment delays
  • Follow up with Managed Care to resolve payment issues
  • Contact patients and third-party payor organizations to secure payment or arrange alternative payment/settlement plans
  • Identify problem delinquencies and recommend their disposition
  • Independently interact with federal, state, third-party payors, agencies, physicians, departmental directors, and outside related vendors
Requirements
  • A high school diploma or equivalent is required
  • At least 1 year of hospital experience dealing with insurance companies, 3 years preferred
  • Knowledge of payor guidelines and contracts are required
  • Experience in appeals with third-party payors, resulting in reimbursement is a plus
  • Must have working knowledge of computer, calculator, and general office equipment
  • 10-key experience
  • On-line Medicare/Medicaid and Commercial verification is preferred

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