Claims Processor

A company is looking for a Claims Process Executive (remote).

Key Responsibilities

Review and verify claim submissions for appropriateness and completeness according to guidelines

Process claims for multiple plans, determining appropriate payments and adhering to coverage guidelines

Maintain customer relations by addressing claims issues and ensuring accurate claim information

Required Qualifications

High School diploma or GED required

Minimum of two to three years of Medicaid and / or Commercial claims payer processing experience

Knowledge of medical terminology, CPT-4, ICD-9, ICD-10, HCPCS, ASA and UB92 Codes

Experience in navigating multiple systems and using dual monitors

Proficient in Microsoft Office - Excel, Word, and Outlook