Medical Claims
1 month ago
Responsibilities:
• Audit medical claims to ensure accuracy and compliance with policies
• Handle appeals related to medical claims
• Use Allscripts and Cerner Technologies to manage and process claims
• Perform billing functions related to medical claims
• Administer claims as per the guidelines of the CMS Platform
• Utilize Cl Programming for efficient claims processing
• Manage benefit functions related to medical claims
• Ensure accurate record-keeping of all claims data
• Resolve customer inquiries related to medical claims
• Monitor customer accounts and take appropriate action as needed• Proficiency in using Allscripts software for medical claims processing
• Familiarity with Cerner Technologies for managing healthcare information
• Knowledge in CL Programming for efficient data processing
• Proficiency in using the CMS Platform to manage content and customer data
• Ability to work with various computer programs related to medical claims processing
• Experience in handling appeals and claim disputes
• Strong auditing skills to ensure accuracy in claims processing
• Understanding of benefit functions within the insurance industry
• Knowledge of billing functions related to medical claims
• Experience in claim administration, including processing, adjusting, and paying claims.
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Medical Claims Specialist
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Claim Auditor I
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