Medical Claims Processor
Company Overview: Our Managed Care Facility is a reputable healthcare services provider committed to delivering excellence in patient care. We are currently seeking a detail-oriented and experienced Medical Claims Processor to join our team. If you have a strong background in healthcare claims processing and enjoy working in a dynamic environment, we invite you to apply for this exciting opportunity.
Position: Medical Claims Processor
Location: Remote
Job Type: Full-Time
Responsibilities:
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Claims Verification:
- Review and verify medical claims for accuracy and completeness.
- Ensure that all necessary documentation is attached to support the claims.
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Data Entry:
- Accurately input claim information into the designated database or claims processing system.
- Update and maintain electronic records of claims.
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Adjudication:
- Evaluate claims against established policies and procedures.
- Determine the eligibility of claims for payment and process accordingly.
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Communication:
- Communicate with healthcare providers and insurance companies to gather additional information when needed.
- Address inquiries and resolve issues related to claims.
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Coding:
- Assign appropriate medical codes to claims for billing purposes.
- Ensure compliance with coding standards and guidelines.
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Quality Assurance:
- Conduct quality checks on processed claims to minimize errors and discrepancies.
- Collaborate with the quality assurance team to enhance process efficiency.
Qualifications:
- Previous experience as a Medical Claims Processor or in a similar role.
- Experience with Medicare/Medicaid
- Knowledge of medical coding, billing, and claims processing procedures.
- Proficiency in using claims processing software and databases.
- Detail-oriented with strong analytical and problem-solving skills.
- Excellent communication and interpersonal abilities.
Benefits:
- Competitive salary.
- Comprehensive health and wellness benefits.
- Opportunities for professional development and advancement.
- Collaborative and inclusive work environment.