Medical Claims Investigator

A company is looking for a Payment Integrity Coordination of Benefits Medical Investigator. Key Responsibilities Review medical paid claims to ensure accurate processing against provider contracts Utilize data mining techniques to analyze hospital and physician claims for errors Promote a collaborative team environment focused on achieving production and quality goals Required Qualifications and Education Minimum high school diploma or GED with two years of experience in medical claims investigation or data mining Preferred medical billing and coding certification and a bachelor's degree in a relevant field Knowledge of coding edits and medical claim reimbursement structures Familiarity with automated medical claims payment systems Advanced computer skills, particularly in Microsoft Excel