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Claims Examiner I

Company: Christus Health
Location: Irving
Posted on: December 4, 2019

Job Description:

The Claims Examiner is responsible for processing UB and CMS 1500 claims, performing data entry and claim pend issue resolution within the quality and production requirements. Major Responsibilities
Meet and/ or exceed claims processing production requirements
Maintain statistical accuracy of 97%, and financial accuracy of 98%
Correct DoD error report as needed
Provide excellent customer service to internal and external customers
Other duties as assigned by management
Collaborate with and maintain open communication with all departments within CHRISTUS Health to ensure effective and efficient workflow and facilitate completion of tasks/goals
Follow the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI) Requirements
High school diploma or equivalent, some college preferred
Knowledge of HCFA, Medicare and TDI regulations
Excellent 10-key and computer skills
Requires excellent data entry speed and accuracy, working with large volumes of input
Knowledge of CPT, ICD-9 and medical terminology
Good written and verbal skills
Preferred: Claims processing experience - Medicaid, Medicare Advantage, Health Exchange and Tricare

Keywords: Christus Health, Irving , Claims Examiner I, Other , Irving, Texas

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