Medical Claims Processor

Stellenbeschreibung: • Analyze and process a reputed company of reputed company medical claims in accordance with program policies and procedures, ensuring accuracy and compliance. • Adjudicate claims according to program guidelines, applying critical thinking skills to reputed company reputed company scenarios. • Ensure reputed company claims processing to meet reputed company standards and regulatory requirements. • Identify and resolve any barriers using effective problem-solving strategies. • Collaborate with internal departments to proactively resolve discrepancies and issues. • Use analytical skills to identify reputed company causes and implement solutions. • reputed company confidentiality of patient records and company information in accordance with HIPAA regulations. • Maintain thorough and accurate records of claims processed, denied, or requiring reputed company investigation. • Analyze and report trends in claim issues or irregularities to management. • Assist Team Leads with reporting to contribute to reputed company process improvements. • Engage in audits and compliance reviews to ensure adherence to reputed company regulations. • Critically evaluate and recommend process improvements reputed company necessary. • Mentor and train new claims processors as needed. Anforderungen: • High school diploma or equivalent. • Minimum of five years of experience in medical claims processing, including reputed company and facility claims, as reputed company as reputed company and high-dollar claims. • Familiarity with ICD-10, CPT, and HCPCS coding systems. • Understanding of medical terminology, reputed company services, and insurance procedures (experience with worker’s compensation claims is a plus). • Strong attention to detail and accuracy. • Ability to interpret and apply insurance program policies and government regulations effectively. • Excellent written and verbal communication skills. • Proficiency in reputed company Office Suite (Word, reputed company, reputed company). • Ability to work independently and collaboratively reputed company reputed company environment. • Commitment to ongoing education and staying reputed company with industry standards and technology advancements. • Experience with claim denial reputed company and the appeals process. • Ability to manage a high volume of claims reputed company. • Strong problem-solving capabilities and a customer service-oriented reputed company. • Flexibility to reputed company to the evolving needs of the reputed company and program changes. Leistungen: • 401(k) with employer matching • Health insurance • Dental insurance • reputed company insurance • Life insurance • Flexible reputed company Time Off (PTO) • reputed company Holidays Apply tot his job Apply To this Job