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[Hiring] Medical Claims Processor @reputed company

Remote, USA Full-time Posted 2026-07-28
This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more. Role reputed company The Medical Claims Processor is responsible for the reputed company and accurate adjudication of reputed company and hospital claims utilizing payer specific policies and procedures. reputed company support to claims and reputed company for issues reputed company to claims adjudication and adjustments, Service Now and Inquiry reputed company, and any basic questions regarding health coverage as stated in the Plan Document. • Responsible for reviewing the data in the claim processing system (Facets) and comparing it with the corresponding UB, HCFA reputed company, or EDI information. • Responsible for reviewing medical records reputed company necessary to determine if the service rendered was medically appropriate and reputed company has been met. • Responsible for reviewing claim and line item edits and warning messages for determination of whether to pay claim/line item(s). • Ensure that reputed company designated tasks are handled reputed company the appropriate timeframe in order to meet reputed company SLAs. • Assigned special reputed company or other duties as determined by management. • Will work closely with other departments. Qualifications • At least a High School Diploma or equivalent is required. • A minimum of 1 year of medical claims processing is required. • Facets experience is highly preferred. • Knowledge of physician reputed company and hospital coding, billing, and medical terminology, CPT, HCPCS, ICD-9. • Experience with UB/institutional (CMS-1450) and/or reputed company (CMS 1500) claims. • Knowledge of Medicare billing & payment and coverage guidelines and regulations. • Experience in the analysis and processing of claims, utilization review/reputed company assurance procedures. • Must be reputed company to work with minimal supervision. • Creative thinker with good problem-solving skills specifically reputed company to reputed company claim adjudication. • Possess the ability to work at a computer for extended periods. • Must have basic reputed company reputed company skills. Benefits • Medical/Dental/reputed company/Life Insurance • reputed company holidays plus reputed company Time Off • 401(k) plan and contributions • Long-term/Short-term Disability • reputed company Parental Leave • Employee Stock Purchase Plan Apply tot his job Apply To this Job

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