Claims Examiner 1

Industry

Admin and Secretarial

Advert ID

USA_447823

Location

Bluffton

Job Type

Temporary

Hours

Full-Time

Salary Range

USD13.00-14.00 per year

No. of Openings

1

Branch Information

Brunswick, GA - (USA) 122 Scranton Connector Suite 108 GA Brunswick , GA - 31525 Phone : 912-265-7319

ContactNumber

912-265-7319

Job Description

Operate data entry device, such as keyboard. Duties may include verifying data and preparing materials for keying, coding or printing.

JOB SUMMARY



Responsible for the review, evaluation and processing of medical claims. Applies proper claim concepts, rules and practices, ensuring accuracy and timeliness of claims payment through demonstrated knowledge of medical terminology, health insurance plans and medical billing concepts. Willingness to learn different claims platforms and also our clients claims platforms when necessary. Display initiative and ability to work independently on investigation and research of claim inquiries and refer questionable claims appropriately for escalation. Exhibit good written and oral communication skills when interacting with peers and clients. Confirm member eligibility and claim pricing. Verify authorization and service appropriateness. Comply with departmental policies, procedures and goals. Be a team player and have the ability to adapt to different personalities and situations. Be professional in your work. Other responsibilities as necessary.