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Plans examiner Jobs in Tucson, AZ

Last updated: 1 day ago
Medical Claims Examiner

Medical Claims Examiner

Next Step Systems – Recruiters for Information Technology Jobs Top IT Recruiting FirmTucson, AZ, USA
Full-time
Medical Claims Examiner, Tucson, AZ.The responsibilities of the Medical Claims Examiner consist of processing claims data and adjudicating medical and inpatient claims received from all provider ty...Show moreLast updated: 30+ days ago
Senior Financial Functional Consultant - Advisory Workday Success Plans

Senior Financial Functional Consultant - Advisory Workday Success Plans

Canada Workday ULCAZ, USA
Remote
Full-time
We are seeking people who love to help customers overcome Financial technology challenges and who feel rewarded by driving high levels of customer satisfaction. The ideal candidate helps people to u...Show moreLast updated: 30+ days ago
Michigan Commercial Title Examiner (Remote)

Michigan Commercial Title Examiner (Remote)

95-2566122 First American Title Insurance CoUSA, Arizona, Remote
$25.00–$33.00 hourly
Remote
Full-time
Join a team that puts its People First! First American's National Production Services division provides global title and escrow production support across all channels within First American Title in...Show moreLast updated: 30+ days ago
  • Promoted
Title Examiner

Title Examiner

VirtualVocationsTucson, Arizona, United States
Full-time
A company is looking for a Title Examiner (Remote).Key ResponsibilitiesPerform title examination and analyze the chain of title for residential propertiesAbstract and analyze records to determine o...Show moreLast updated: 1 day ago
Auto Liability Bodily Injury Claims Examiner

Auto Liability Bodily Injury Claims Examiner

SedgwickRemote, Arizona, US
$70,000.00 yearly
Full-time
Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague.A career at Sedgwick means experiencing our culture of caring.It means having fle...Show moreLast updated: 30+ days ago
CDL EXAMINER - CUSTOMER SERVICE REPRESENTATIVE 4

CDL EXAMINER - CUSTOMER SERVICE REPRESENTATIVE 4

Arizona Official Website of State of ArizonaTUCSON
$40,207.02 yearly
Administer written and road tests for Commercial / Non-Commercial Driver License applicants and administer Special Performance Evaluations (SPE) for customers requiring special equipment in order to ...Show moreLast updated: 30+ days ago
SR Financial Functional Consultant - Workday Success Plans - Spend Management

SR Financial Functional Consultant - Workday Success Plans - Spend Management

Workday, Inc.AZ, USA
Remote
Full-time
Would you enjoy learning new things in a fast paced environment? Do you have an appetite for variety and challenging business problems to solve? Are you a great communicator who can clearly articul...Show moreLast updated: 30+ days ago
Medical Claims Examiner

Medical Claims Examiner

Next Step Systems – Recruiters for Information Technology Jobs Top IT Recruiting FirmTucson, AZ, USA
30+ days ago
Job type
  • Full-time
Job description

Medical Claims Examiner, Tucson, AZ

The responsibilities of the Medical Claims Examiner consist of processing claims data and adjudicating medical and inpatient claims received from all provider types and lines of business, reviewing and resolving rejected and / or denied claims, conducting research and analysis of claims and facilitating resolution of specific claims issues. The Medical Claims Examiner is also responsible for monitoring copays, deductibles, insurance verification, and authorizations, analyzing incoming and outgoing revenue sources and measuring different financial cycles on behalf of EHR software customers, as well as maximizing reimbursements and developing effective policies for billing and claim processing. This position is 100% Onsite. There is no flex schedule for this opportunity, hours are from 8am-5pm. Must have experience in medical records, scanning and sending releases to other agencies.

Medical Claims Examiner Responsibilities :

Submit claims and encounters in a timely manner.

Review and resolve rejected, pended, and / or denied claims within expected timeframes.

Coordinate claim adjustments with the customer.

Identify revenue cycle issues and implement solutions to improve systems and processes.

Respond to calls on claims issues and provide information and resolution in a timely manner.

Provide education and technical support to Claims Examiners and customers regarding claims-related issues through on-line training and in person training.

Produce scheduled reports for leadership and customers.

Prepare written inter-departmental and external correspondence.

Develop and publish formal written guidance for customers to process claims.

Analyze encounter-processing data using statistical methodologies.

Update and maintain electronic billing manual and distribute updates as directed.

Compare business operations and coordinate technical analysis support for upcoming collection of accounts.

Medical Claims Examiner Qualifications :

High School diploma or GED plus five (5) years full-time data entry experience in claims processing, accounting, analysis and adjudication of Medical and / or Behavioral environment.

Must have experience in medical records, scanning and sending releases to other agencies.

Excellent communication skills with coworkers and patients.

Medical claims experience.

Experience in Insurance verification.

Medical records experience.

Patient pay and collections experience.

Insurance Payment review experience.

Claims submission and billing experience.

Experience with ICD10, CPT, HCPCS, and Inpatient coding and billing and knowledge of HIPAA regulations.

Knowledge of Microsoft Excel and 10-key by touch.

Knowledge of and experience working with Electronic Health Records system(s).

Ability to translate customer needs to technical and / or business process solutions.

Ability to effectively work with internal teams across numerous functions and levels.

Ability to quickly learn complex business processes and understand the underlying transactional systems.

Strong customer service skills and abilities.

Exceptional communication skills, including strong customer-facing presentation and facilitation skills.

Ability to work on multiple projects.

Strong attention to detail and follow-through skills.

Experience working in a team-oriented, collaborative environment.

Strong analytical and problem-solving abilities.

Comply with all policies, procedures and contractual / regulatory requirements.

Within one month of hire, complete new-employee orientation.

Complete and provide all training as directed.

Provide documentation related to formal education, training, and compliance with general and physical requirements as requested.

Demonstrate ethical behavior.

Demonstrate dependability by reporting to work on-time and working required hours / days.

Achieve monthly goals developed with the supervisor.

Able to speak, read and write in both English and Spanish is a big plus.

Keywords : Tucson AZ Jobs, Medical Claims Examiner, ICD10, CPT, HCPCS, HIPAA Regulations, In-Patient Coding, In-Patient Billing, Electronic Health Records, EHR, Excel, Data Entry, Claims Processing, English, Spanish, Medical, Healthcare, Arizona Recruiters, Information Technology Jobs, IT Jobs, Arizona Recruiting

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We help companies that are looking to hire Medical Claims Examiners for jobs in Tucson, Arizona and in other cities too. Please contact our IT recruiting agencies and IT staffing companies today! Phone 630-428-0600 ext. 11 or email us at [email protected]. Click here to submit your resume for this job and others.

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