Talent.com
Claims Analyst - MHT

Claims Analyst - MHT

The Health Plan of West Virginia IncCharleston, WV, US
12 days ago
Job type
  • Full-time
Job description

Job Description

Job Description

Under the direction of the Manager of Claims, the reviewer performs initial review of claims, including HCFA 1500 and UB 04 claims. Reviewer must meet or exceed production and quality standards and follow documented policies and procedures.

Required :

  • High dipolma or equivalent.
  • Ability to follow written directions and work independently.
  • Familiarity with medical terminology, CPT and ICD-10 coding is required.
  • Computer and typing experience is required.

Desired :

  • Previous claims processing.
  • Experience in billing or physician office experience is preferred.
  • Responsibilities :

  • Performs initial review of all claim edits as directed. Completes or routes all reviews in accordance with time parameters established by The Health Plan.
  • Reviews each claim flag in sequence, totally completing one at a time in accordance with established criteria / payment guidelines.
  • Reports patterns of incorrect billing and utilization to manager or claims coordinator.
  • Advises management of items that are unclear or that are not addressed in the established criteria / payment guidelines.
  • Maintain a quality rating of 98%.
  • Processes 15-20 claims per hour.
  • Consistently displays a positive attitude and acceptable attendance.
  • Participate in external and / or internal trainings as requested.
  • 8 : 00am - 5 : 00pm

    40

    Create a job alert for this search

    Mht • Charleston, WV, US

    Related jobs
    • Promoted
    Purchasing Manager

    Purchasing Manager

    KSSPoca, WV, US
    Full-time
    American Equipment Holdings, is one of the leading Industrial Weighing solutions providers in the United States.Over the years, our ability to grow and set ourselves apart from the competition is t...Show moreLast updated: 30+ days ago
    • Promoted
    Employment application

    Employment application

    Mistras Group Inc. - ServicesUnited, WV, US
    Full-time
    Employment decisions including initial hiring and all matters involving the terms and conditions of employment will be made without regard to any protected class under applicable law.If hired, the ...Show moreLast updated: 30+ days ago
    • Promoted
    Physician (MD / DO) - Internal Medicine - General / Other in Madison, WV

    Physician (MD / DO) - Internal Medicine - General / Other in Madison, WV

    LocumJobsOnlineMadison, WV, US
    Full-time +1
    LocumJobsOnline is working with CompHealth to find a qualified Internal Medicine MD in Madison, West Virginia, 25130!.Madison, West Virginia, is an ideal place for physicians seeking both professio...Show moreLast updated: 25 days ago
    • Promoted
    Travel Nurse RN - Home Health - $2,300 per week in Ripley, WV

    Travel Nurse RN - Home Health - $2,300 per week in Ripley, WV

    TravelNurseSourceRipley, WV, US
    Full-time +1
    TravelNurseSource is working with Core Medical Group to find a qualified Home Health RN in Ripley, West Virginia, 25271!. Client in WV seeking Registered Nurse : Home Health.We are looking for a heal...Show moreLast updated: 10 days ago
    • Promoted
    Senior Product Manager, Digital Mortgage (Remote)

    Senior Product Manager, Digital Mortgage (Remote)

    ExperianUnited, WV, US
    Remote
    Full-time
    Experian is a global data and technology company, powering opportunities for people and businesses around the world.We help to redefine lending practices, uncover and prevent fraud, simplify health...Show moreLast updated: 15 days ago
    • Promoted
    Travel Certified Occupational Therapist Assistant (COTA) - $1,412 per week in Spencer, WV

    Travel Certified Occupational Therapist Assistant (COTA) - $1,412 per week in Spencer, WV

    AlliedTravelCareersSpencer, WV, US
    Full-time +1
    AlliedTravelCareers is working with Infojini Healthcare to find a qualified Certified Occupational Therapist Assistant (COTA) in Spencer, West Virginia, 25276!. Occupational Occupational Therapist ...Show moreLast updated: 4 days ago
    • Promoted
    Claims Analyst

    Claims Analyst

    The Health Plan of West Virginia IncCharleston, WV, US
    Full-time
    Under the direction of the Manager of Claims, the reviewer performs initial review of claims, including HCFA 1500 and UB 04 claims. Reviewer must meet or exceed production and quality standards and ...Show moreLast updated: 7 days ago
    Healthcare Claims Analyst - Remote

    Healthcare Claims Analyst - Remote

    Fortuna BMCCharleston, WV, USA
    Remote
    Full-time
    Quick Apply
    We are seeking a detail-oriented and motivated Healthcare Claims Analyst to join our team.In this role, you will be responsible for reconciling healthcare payments, posting claims, generating invoi...Show moreLast updated: 23 days ago
    • Promoted
    Travel Home Health RN - $2,300 per week

    Travel Home Health RN - $2,300 per week

    Core Medical GroupRipley, WV, United States
    Full-time +2
    Core Medical Group is seeking a travel nurse RN Home Health for a travel nursing job in Ripley, West Virginia.Job Description & Requirements. Client in WV seeking Registered Nurse : Home Health.We ar...Show moreLast updated: 6 days ago
    • Promoted
    Travel Occupational Therapist (OT) in Spencer, WV

    Travel Occupational Therapist (OT) in Spencer, WV

    AlliedTravelCareersSpencer, WV, US
    Full-time +1
    AlliedTravelCareers is working with Lancesoft Inc.Occupational Therapist (OT) in Spencer, West Virginia, 25276!.We are currently seeking qualified candidates for Occupational Therapy.Shift 5x8 Days...Show moreLast updated: 30+ days ago
    • Promoted
    Director of Product Management, Curation (Remote)

    Director of Product Management, Curation (Remote)

    ExperianUnited, WV, US
    Remote
    Full-time
    Experian is a global data and technology company, powering opportunities for people and businesses around the world.We help to redefine lending practices, uncover and prevent fraud, simplify health...Show moreLast updated: 30+ days ago
    • Promoted
    LF Sales Rep

    LF Sales Rep

    Leaf HomeNitro, WV, US
    Full-time
    LeafFilter Gutters and Gutter protection.No cold calling- no sweepstake giveaway- real people confirming your leads.Are you tired of cold calling looking for new business? Tired of the constan...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Occupational Therapist (OT) - $1,566 per week in Spencer, WV

    Travel Occupational Therapist (OT) - $1,566 per week in Spencer, WV

    AlliedTravelCareersSpencer, WV, US
    Full-time
    AlliedTravelCareers is working with Care Career to find a qualified Occupational Therapist (OT) in Spencer, West Virginia, 25276!. Occupational therapists treat disabled, ill, or injured patients wi...Show moreLast updated: 4 days ago
    • Promoted
    Claims Business Analyst

    Claims Business Analyst

    ForhyreUnited, WV, US
    Full-time
    We are looking for a Claims Business Analyst who will be the vital link between our information technology capacity and our business objectives by supporting and ensuring the successful completion ...Show moreLast updated: 30+ days ago
    • Promoted
    Locum Physician (MD / DO) - Emergency Medicine in Spencer, WV

    Locum Physician (MD / DO) - Emergency Medicine in Spencer, WV

    LocumJobsOnlineSpencer, WV, US
    Full-time
    LocumJobsOnline is working with Weatherby Healthcare to find a qualified Emergency Medicine MD in Spencer, West Virginia, 25276!. If this opportunity sounds right for you, give us a call today to sp...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Home Health RN

    Travel Home Health RN

    Core Medical GroupRipley, WV, US
    Permanent +1
    Core Medical Group is seeking a travel nurse RN Home Health for a travel nursing job in Ripley, West Virginia.Job Description & Requirements. Client in WV seeking Registered Nurse : Home Health.W...Show moreLast updated: 4 days ago
    • Promoted
    • New!
    Solutions Engineer

    Solutions Engineer

    VirtuousUnited, WV, US
    Full-time
    Virtuous is on a mission to inspire global generosity by helping nonprofits build better relationships with their donors. We offer a modern software platform that provides mid-sized charities with e...Show moreLast updated: 15 hours ago
    • Promoted
    Travel Certified Occupational Therapy Assistant

    Travel Certified Occupational Therapy Assistant

    Skyline Med Staff AlliedSpencer, WV, US
    Full-time
    Skyline Med Staff Allied is seeking a travel Certified Occupational Therapy Assistant for a travel job in Spencer, West Virginia. Job Description & Requirements.Certified Occupational Therapy As...Show moreLast updated: 8 days ago