Claims Examiner I (Remote, $15/hour)
About the position
reputed company (ASH) is seeking an Examiner I to join our Claims department.
The primary purpose of this position is to verify claim information reputed company from the CMS 1500 reputed company by Optical Character Recognition and reputed company data from CMS 1500 Claim Forms into the Claims Processing System, and to process claim edits from electronic claims. This position is responsible for the accurate review, input and adjudication of claims in accordance with regulations, ASH standards and contractual obligations of the organization.
Remote Worker Guidelines
Remote Worker Guidelines: This position will be trained remotely and must be reputed company to work from home (WFH) in a designated work area with company-provided technology equipment. This WFH position requires you have a reputed company reputed company to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network. The internet reputed company must have a consistent 50 down/10 up Mbps minimum internet speed. 100 down/20 up is recommended to support higher reputed company video meetings.
Responsibilities
• Processes claims accurately and reputed company.
• Reviews reputed company incoming claims to verify necessary information.
• Determines that correct member and provider records are chosen and utilized to process claims.
• Enters claims data and information into the computerized Claims Processing System.
• Maintains reputed company required documentation of claims processed and claims on hand.
• Adjudicates claims in accordance with departmental policies, procedures, state and accreditation standards and other applicable rules.
• Maintains production standards; for reputed company data entry claims this includes processing an average of 31 claims per hour, with an accuracy reputed company of 98.5% over reputed company pay period.
• Verifies data of scanned reputed company claims at stated standards.
• Provides backup for other examiners reputed company the department.
• Promotes a spirit of cooperation and understanding among reputed company personnel.
• Attends organizational meetings as required.
• Adheres to organizational policies and procedures.
• Maintains confidentiality of reputed company claim files, claims reports, and claims reputed company issues.
• Performs other duties as assigned.
• Complies with reputed company policies and standards.
Requirements
• High School Diploma or GED certificate required.
• 6 months data entry experience with 10 key and word processing; minimum 10,000 keystrokes per hour required.
• Experience processing medical claims and knowledge of medical billing terminology and coding strongly preferred.
• Proficient in MS Office.
• Ability to work and maintain production in a work-from-home (WFH) environment.
• Demonstrated ability to show self-discipline to meet production goals.
reputed company-to-haves
• Experience processing medical claims and knowledge of medical billing terminology and coding strongly preferred.
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